# classical csection & healing period



## ksera05 (Apr 14, 2006)

I had a classical c-section July 27th due to pre-e/HELLP syndrome and an extremely premature baby.

What is the usual recommended time for allowing a CLASSICAL incision to heal in order to insure a strong incision when you get pregnant again? I keep finding 6-12 months as a recommendation for low transverse incisions. Is it the same for a classical incision or do they need more time? I can't seem to find any studies or anything on it (although maybe I'm looking in the wrong places) Anyone know?

(not that DH and I are considering another baby anytime soon







I just want to have the information tucked away in the back of my head.)


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## maxmama (May 5, 2006)

Since VBAC isn't a concern with a classical incision, I would expect the healing time to matter less. The concern with the strength of the scar isn't so much to carry to term, but to withstand the stress of labor.


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## OnTheFence (Feb 15, 2003)

Quote:


Originally Posted by *maxmama* 
Since VBAC isn't a concern with a classical incision, I would expect the healing time to matter less. The concern with the strength of the scar isn't so much to carry to term, but to withstand the stress of labor.

I disagree, many ruptures happen before labor begins and is a risk even before labor.

I have read 12-18 months for a classical incision. Most health care providers will tell you you need a full year to heal from that type of abdominal surgery. One concern will be hernias. So take care of yourself and don't rush things.

Kim


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## egoldber (Nov 18, 2002)

I think that OBs/peris are becoming more conservative about this. Your type of C-section (classical on a pre-term uterus) is considered a more dangerous kind of scar than even a "simple" classical incision. Your peri group is known as being the most conservative in the area, so I wouldn't be surprised if they recommended waiting at least 1 year if not two. And that's even with a planned C-section delivery, perhaps as early as 36 weeks. (I'm just saying this would probably be their recommendation, not that I necessarily agree with it.) But it seems like peris are pushing more and more for earlier deliveries.

In my situation, the peri I consulted recommended 9 months and said if it weren't for my advanced age







: and past history of early miscarriages







, he would have recommended waiting a full 2 years.

I don't, however, know of any studies that have looked specifically at inter-delivery intervals for your particular situation. I think your peri would be making an educated guess at best.


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## doctorjen (May 29, 2003)

Quote:


Originally Posted by *maxmama* 
Since VBAC isn't a concern with a classical incision, I would expect the healing time to matter less. The concern with the strength of the scar isn't so much to carry to term, but to withstand the stress of labor.

As OnTheFence said, scars can rupture prior to labor, even, and this is more common with a classical incision where the incision is into the uterine fundus, not the lower uterine segment which heals well, and has more connective tissue which holds better. The only uterine rupture I've personally seen was with a previous classical scar, and the rupture occurred at 28 weeks.


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## maxmama (May 5, 2006)

Yes, but the issue of time between pregnancies/rupture has only been looked at in terms of rupture with subsequent term pregnancy/labor. So while there may be more risk of preterm rupture (which I agree can happen before labor, and to me makes the issue of an automatic repeat section for LTCS incisions much more iffy), there's not a lot of data on it. But thank you for clarifying!


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