Success rate of vaginal delivery with scarred uterus

As the name suggests, a scarred uterus refers to a uterus that has suffered some kind of injury and left scars. Especially women who choose cesarean section for their first child generally have a scarred uterus. At this time, the next pregnancy may require an incision in the lower part of the uterus, which will then form a scarred uterus. Many people believe that if they choose to have a caesarean section for their first child, they must also have a caesarean section for the second child. Is this really the case? What is the success rate of natural birth for women with scarred uterus?

What is a uterine scar?

A scarred uterus, also known as a scarred uterus, refers to a uterus that leaves scars after an injury. Uterine scarring does not necessarily occur in women with a scarring constitution, but most commonly occurs in mothers who have undergone cesarean section. Because a cesarean section requires an incision in the lower part of the uterus, a scar will form on the anterior wall of the uterus. In addition, women who have undergone gynecological and obstetric surgeries such as myomectomy, uterine perforation or rupture repair, and metroplasty are prone to developing uterine scars.

Pregnancy and childbirth for mothers with uterine scars are more dangerous than for normal mothers. Doctors generally recommend that mothers who have had a cesarean section consider getting pregnant again two years after giving birth, because a scarred uterus will form after a cesarean section. If a mother becomes pregnant when the uterus has not fully healed, the fetus will develop, the uterus will enlarge, the uterine wall will thin, and the connective tissue at the cesarean section incision will lack elasticity. The fresh scar can easily rupture in the late pregnancy or during delivery, causing massive abdominal bleeding and even life-threatening.

Women with uterine scars do not have any special characteristics. Some women may experience painless vaginal bleeding and abdominal pain. Clinically, the examination is mainly based on ultrasound. Therefore, when a mother experiences similar symptoms in her daily life after a caesarean section, it is best to take it seriously and go to the hospital for examination as soon as possible. If a mother with a uterine scar becomes pregnant again, she can only choose vaginal delivery if she meets the indications for natural delivery.

Can a woman with a scarred uterus give birth naturally?

If a woman with a scarred uterus is pregnant, she can only choose a natural birth if she meets the indications for natural birth. Generally, mothers who have undergone a low-lying uterine transverse cesarean section and have no contraindications to vaginal birth can have a vaginal trial birth if they meet the following conditions:

1. Had one low transverse cesarean section (if a conventional or T-shaped incision or extensive transuterine fundus surgery has been performed, vaginal delivery is not suitable);

2. The transverse diameter of the pelvis should be large enough (generally required to be greater than 15 cm);

3. No history of uterine scarring or uterine rupture (it is not suitable if there have been two uterine scarrings and no vaginal delivery);

4. During the entire natural delivery period, doctors can be present at any time to monitor delivery and perform emergency cesarean sections;

5. Anesthesia can be given immediately and emergency cesarean section personnel can be on site at any time.

Only when the above conditions are met and the doctor has examined the mother and confirmed that her condition permits, can a normal birth be performed. If during the trial birth, there are abnormal delivery conditions such as prolonged labor, maternal bleeding, etc., the doctor will ask the mother to change the delivery method and perform a caesarean section to ensure the safety of mother and child. At this time, it is best for the mother to cooperate with the doctor's advice.