Verifying the type of incision used for a previous cesarean

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Verifying the type of incision used for a previous cesarean

You and your doctor will review your medical records to verify the type of cesarean incision(s) you have had. Your visible scar on the skin may not be the same as the incision made in the uterus.

For more than 20 years, doctors typically have made a low, side-to-side (transverse) incision across the uterus for a cesarean delivery. However, for an emergency cesarean or delivery of a very premature (28 to 32 weeks) baby by cesarean, a different type of incision may have been used to save time or to safely remove your baby.

• If an incision was made up and down (vertically) into the upper part of the uterus during a previous cesarean delivery, vaginal birth after cesarean (VBAC) is not recommended. This type of incision greatly increases the risk of uterine rupture during labor.
• If an incision was stitched with a single-layer closure, rather than a double-layer, the risk of uterine rupture is higher during VBAC.^{1 2}
• If the incision was made from side to side (transverse) and low on the uterus, VBAC is generally considered safe for most women.
• If an incision was made up and down (vertically) into only the lower part of the uterus during a previous cesarean delivery, VBAC is as safe as with a low transverse incision scar.²

References

Citations

1. Bujold E, et al. (2002). The impact of single-layer or double-layer closure on uterine rupture. American Journal of Obstetrics and Gynecology, 186(6): 1326–1330.

2. American College of Obstetricians and Gynecologists (2004). Vaginal birth after previous cesarean delivery. ACOG Practice Bulletin No. 54. Obstetrics and Gynecology, 104(1): 203–212.

Credits

Last updated:	April 20, 2007
Author:	Kathe Gallagher, MSW
Reviewed By:	Joy Melnikow, MD, MPH - Family Medicine, Kirtly Jones, MD - Obstetrics and Gynecology
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC