Jo,
I would absolutely agree with your first statement, heard it many times,
"got in & saved/rescued your baby, just in the nick of time" !
I am such a hero!
With the second part: whilst very supportive of BAC I think labouring
with a
uterus which has already dehisced & is subsequently heavily scarred is
really pushing the boundaries of safety.
However: as long as the mother is well informed ( & being well informed
means knowing the down side as well as the up side) about the risks & not
intending to allocate blame if the outcome is unfavourable ie a second UR
(
hysterectomy etc, plus or minus a fetal death) then she can do what ever
she
chooses.
I have seen in OT the uterus of a woman booked for a repeat EL LUSCS, not
in
labour, 38/40 with a dehisced area easily 5 cms in the old scar & no
apparent ill effects for mother or baby. Normal obs, normal CTG, normal
fetal mvmts. Absolutely no sign before OT that there was anything amiss.
Amazing.
She had been offered BAC & chose
LUSCS...............................what if ?
With kind regards
Brenda Manning
www.themidwife.com.au
----- Original Message -----
From: Dean & Jo
To: [email protected]
Sent: Monday, January 23, 2006 11:15 PM
Subject: [ozmidwifery] VBAC afterdehsicence or UR?
not trying to be controversial (honest!) just wanting to think outside
norm...how many times have I heard the story of an ob saying to a woman
when
giving her the repeat cs (for a 'failed vbac attempt not linked to a
rupture) "oh the scar was so thin it could have ripped open at any
second...lucky I saved you from it". (well I am TRYING not sound too
facetious)
I suppose like anything we must look at rationale for the first event.
IF a
rupture did occur you could conclude that the repair to the uterus would
be
quite extensive IF she managed to not lose the uterus- hence the risks
for
future rupture would increase. But a dehiscence has not been proven to
be a
serious concern according to the investigation I have done in the last
almost 9 years. There is speculation that a scar can slightly part with
no
harmful effects.
Just asking questions....don't they just HATE informed consumers! ;o)
love Jo
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of
Janet Fraser
Sent: Monday, January 23, 2006 8:40 PM
To: [email protected]
Subject: *****SUSPECTED SPAM***** Re: [ozmidwifery] VBAC afterdehsicence
or
UR?
You made all my points, Jo.
: )
J
----- Original Message -----
From: Dean & Jo
To: [email protected]
Sent: Monday, January 23, 2006 8:46 PM
Subject: RE: [ozmidwifery] VBAC after dehsicence or UR?
I would have to look for the research (we all know how 'fair' research
can
be!) but the stated contra-indicators for vbac is previous rupture. Now
it
doesn't actually state if the chances of another rupture are higher than
a
normal scar or whether it is a case of "dam! Not going to let that happen
again!" attitude. You could argue I suppose that even a dehiscence that
required repair would be considered the same as a repeat cs....??
Perhaps
no vbac after one rupture/dehiscence would be based on fear and/or
presumption. Similar to the situation where a woman loses a baby during
labour there is the assumption that she will want a cs next time.???
jo
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of
Janet Fraser
Sent: Monday, January 23, 2006 3:37 PM
To: [email protected]
Subject: [ozmidwifery] VBAC after dehsicence or UR?
Hi all,
does anyone know of research on VB after UR? I was asked this:
So if you've had a scar come apart to the point where the baby was on its
way out via the DIY sunroof, and the ob says he would have had to cut me
open to stitch it up even if I had pushed the baby out, would that make
VBA2C too risky?
Thanks in advance,
J
Joyous Birth
Home Birth Forum - a world first!
http://www.joyousbirth.info/forums/
Attending births is like growing roses. You have to marvel at the ones
that
just open up and bloom at the first kiss of the sun but you wouldn't
dream
of pulling open the petals of the tightly closed buds and forcing them to
blossom to your time line.
~Gloria Lemay~
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