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C-section - series: Procedure, part 3

C-section - series Illustrations: Normal anatomy Indications Procedure, part 1 Procedure, part 2 Procedure, part 3 Procedure, part 4 Procedure, part 5 Procedure, part 6 Aftercare

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.

Update Date: 5/26/2008

Updated by: Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; and . Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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