Hi Sally,

Based on the (limited) stuff I have read on uterine surgery - when I was doing my personal study for my VBACs - from a birth point of view she would be treated the same as a woman who has had a classical caesarean section and a caesarean would be recommended for delivery over a vaginal birth.  The risk of uterine rupture where the fundus has been infiltrated by surgery or injury is about 8% according to the studies.  Most of the ruptures occurred in labour although there were a couple of prelabour ones - you might want to check on Pubmed for the details.

However on the positive side there was nothing I read that indicated that a woman who has had a classical csec or uterine surgery cannot go on to have a healthy pregnancy.  And there was nothing to indicate that her chances of getting and maintaining a pregnancy were any less than for other women in her age group.  The only other major risk that was mentioned was an increased chance of placental accreta.

I did an article on uterine rupture you can find in the magazine section of Birthrites Healing After Caesarean - it has some limited information on this in it - but the document is actually written primarily for women with LSCS.  http://birthrites.edsite.com.au/

Debby



 

>From: "Sally Williams" <[EMAIL PROTECTED]>
>Reply-To: [EMAIL PROTECTED]
>To: "Ozmidwifery List" <[EMAIL PROTECTED]>
>Subject: [ozmidwifery] uterine surgery
>Date: Sun, 22 Dec 2002 22:18:59 +1100
>
>A colleague of mine has had uterine surgery to remove a myometrial fibroid in the fundus of the uterus To remove it completely, as it was quite large, the uterus was cut through to the endometrium. What would be her chances of carrying a pregnancy to term and how safe would it be for her to have a labour and a vaginal birth? She is also in her late 30's?
>
>Sally


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