For most women with one prior cesarean and a low
transverse incision VBAC is a good option and they should be counseled and offered a TOLAC.
According to the American College of Obstetricians and Gynecologists (ACOG), if you had a previous cesarean with a low
transverse incision, the risk of uterine rupture in a vaginal delivery is.2 to 1.5 %, which is approximately 1 chance in 5001.
Most women with one previous cesarean delivery with a low -
transverse incision are candidates for and should be counseled about and offered TOLAC.
Women with one previous cesarean delivery with a low -
transverse incision, who are otherwise appropriate candidates for twin vaginal delivery, are considered candidates for TOLAC.
«Bikini Cut» C - Section Incision Your obstetrician will probably use a low,
transverse incision during the surgery.
Low
transverse incisions are the most common (top left).
Not exact matches
If you've had one c - section with the typical low -
transverse uterine
incision and are considered a good candidate for VBAC, most studies estimate the risk of rupture during labor to be less than one percent.
This is called a low -
transverse uterine
incision.
The
incision made in the uterine wall for cesarean birth may be
transverse (left) or vertical (right).
The
incision in the wall of the uterus also will be either
transverse or vertical.
The skin
incision may be
transverse (horizontal or «bikini») or vertical, near the pubic hairline.
There are three types of
incisions — low
transverse, which are the most common; classical, which are typically for a quick delivery or pregnancies with complications; and low vertical, which may be used if baby is in an awkward position.
Limited data suggest that external cephalic version for breech presentation is not contraindicated in women with a prior low -
transverse uterine
incision who are candidates for external cephalic version and TOLAC (119 — 121).
The absence of an association may result from the fact that most cesarean
incisions are low
transverse, and the uterine scar type often can be inferred based on the indication for the prior cesarean delivery.
Additionally, early case series did not stratify rupture rates by the type of prior cesarean
incision (eg, low
transverse versus classical)(31).
Although some have questioned the safety of offering TOLAC under these circumstances, two case series, both from large tertiary care facilities, reported rates of VBAC success and uterine rupture similar to those of women with a documented prior low -
transverse uterine
incisions (90, 91).
However, and we share this cautiously and in the interest of full disclosure, ACOG reviewed a single case series and four retrospective studies regarding low - vertical uterine
incision and found these women were just as likely to have a successful VBAC as women with a previous low -
transverse uterine
incision (2004).
- There has only been one previous cesarean delivery and it was done with a low
transverse horizontal
incision (bikini scar).
A sideways, or
transverse,
incision in the lower part of the uterus forms a strong scar with a low risk of rupture in future pregnancies.