Procedure, part 3

Next, the surgeon opens the uterus with either a horizontal or vertical incision, regardless the direction of the skin/abdominal incision. A vertical incision on the uterus causes less bleeding and better access to the fetus, but renders the mother unable to attempt a vaginal delivery (must have another repeat C-section) in the future.

If you end up with a horizontal incision, you will have the option of either going through a trial of labor (TOL) or electing a repeat c-section.

The reason for the differences between the two is that patients with vertical uterine incisions have a much higher chance of rupturing the uterus (8-10%) in the future pregnancies, compared to only 1% in those with horizontal incisions.

Review Date: 6/6/2006
Reviewed By: Audra Robertson, MD, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.

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