EP51| All about Special Scars

In this episode, I am discussing special scars!!

What they are, how they happen, what the risks are and what that means for you if you have a special scar!

If you have one you will more than likely know about it. The surgeons would usually recommend or tell you to “never labour on that scar” or that you are not 

suitable for a VBAC. 

If you haven’t been told anything there is still a chance you have one, and haven’t been told, but I’d say more likely than not they would have said something. 

Today  I’m going to talk about what are the different types of scars, possible reasons for the scars and higher risk factors for uterine rupture. 

First let’s hear a definition of a special scar.  

Definition of Special Scars from Special scars special hope FB page.

A scar resulting from a Classical, Inverted T, J, Low Vertical, Upright T or any other cesarean incision other than the most often used Low Transverse. 

Also, any scar on the uterus from other uterine surgeries, such as myomectomies which is a surgical procedure to remove uterine fibroids.

Let’s talk more about the types of scars and how they can happen and impact a future VBAC

Some handy information from The VBAC Link below with short explanation of the types of special scars. 

Classical Incision

An up-and-down cut made in the upper part of the uterus. This is sometimes done for very preterm cesarean deliveries. It has the highest risk of rupture.

Risk is 4% to 9% 

Listen to ep22 Breana – she had a powerful homebirth with amish midwifes after a classical c-section due to a pre term birth with pre-clampsia. 

T and J incision

These scar types happen when a surgeon needs more room to get the baby out after they have done a low transverse incision. The look like a “T” or a “J”. 

Sometimes they happen on accident as well. These scar types are rare.

EP28 – Lisa Inverted T special space HBAC

Low Vertical Incision

A low vertical incision is made in the lower part of the uterus. These incision types are used when the baby is large, transverse (sideways), or for placenta previa.

I just want to add to this that this type of scar is also a risk factor from babies being down in the pelvis deeply.  Or from babies moving and pulling arms from the shock of being touched. 

Listen to EP 19 – Ashley special scar. 

Here are stats I found from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7396476/

Classic incision 4–9%

Low transverse with T-extension 4–9%

Low vertical incision 1–7%

Low transverse 0.2–1.5%

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Source: ACOG, 1999

Links: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7396476/

I hope you enjoy this episode!

Ashley x 

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Ashley x