# Bandl's Ring aka abnormal retraction ring



## Cian'sMama (Jan 28, 2005)

Hi Mamas,

I am wondering if anyone else has had a Bandls' Ring. In my quest for healing from my vba2c turned repeat cesarean birth I am trying to read what I can on what this is, and sadly I can find very, very little information. Can anyone help?

Thanks!


----------



## Cian'sMama (Jan 28, 2005)

Isn't there anyone out there?! Please share!


----------



## Cian'sMama (Jan 28, 2005)

I know this is a pretty rare thing...still I am surprised that no one has had this! Thought I'd try again....

anyone? anyone know anyone who had this?

thanks!


----------



## mwherbs (Oct 24, 2004)

It is rarely seen anymore because they do c- sections fairly quickly. There is a division zone between the lower segment and the upper segment, a bandl's ring develops in this area it is thought to be associated with impending uterine rupture caused by obstruction that zone becomes thinner and thinner and just above it becomes thickened so you can feel and sometimes see it

The one I know about the baby had both hands at the back of the shoulders with elbows presenting along side the head,in the Victorian era pelvic deformity was a cause of obstruction


----------



## Hemmal (Jun 14, 2011)

I had a c-section after a HBAC attempt; After the surgery (8/26/10) the OB told me that I had developed a Bandl's Ring, but I never could find anyone else that had ever had one or much information at all on these rings.


----------



## Cian'sMama (Jan 28, 2005)

Thanks for the replies! Interesting about the c-sections happening more quickly these days, I hadn't thought of that. In my case it was very obvious, my stomach literally looked like an hourglass. I thought it was bizarre and mentioned it to my MW but she thought nothing of it. A nurse saw it and asked me about it, saying that it looked strange. I told her I agreed, but that no one seemed concerned. I am surprised because it now seems very obvious to me. Anyway, again my thanks for the replies...it is somehow comforting to hear of someone else who either knows about it or has been through it.

Peace!


----------



## Devaskyla (Oct 5, 2003)

This is a really good article about Bandl's ring http://womantowomancbe.wordpress.com/2009/11/03/bandls-ring/


----------



## carolla143 (Mar 15, 2011)

I just had my daughter and after laboring naturally for 24 hours my OB could see the Bandl's Ring just looking at my belly.  Off I went to a c-section. I realized it was rare when during the surgery he made sure to point it out to all the other medical people in the room. At my post-op appointment I intended to ask him about it, particularly if it would affect my ability to delivery vaginally in the future. He wasn't the one who did my post-op appointment and the NP that did it didn't know anything about a Bandl Ring. Soo...I'm waiting for a call back from the OB or from her to give me more information. I'll post again if I get any good/worthwhile information.

I was soo disappointed to have to end up with a c-sect but of course would prefer that over uterine rupture, etc etc etc. I had never heard of it before either.


----------



## Pock29 (Jul 23, 2011)

Hi Ladies.

I am also one of those women who have suffered from a Bandl's Ring back in 2010 with my daughter. Naturally hoping for a smooth progressing labor, it turned to be far from that. I am currently looking into trying to conceive again and have been trying to do some more research on how this may affect me trying to have another. As far as I know from what my past doctor had told me about a Bandl's Ring, it is not a common thing. My doctor had told me that he had only seen one other in the 33 years he had been a Doctor. I had labored for 3 days, consistanly going back and forth to the Hospital from contractions and every time they had sent me home. I was dilated 3 for days before but due to the fact I was not progressing they said they could not keep me. Finally after my water broke they had no choice. I was given medicine to kick start my Labor but it was slow. After a Epidural, and even more hours I finally had made it to a seven and stopped dialating. The baby's heart rate dropped, she was stressed and so a C-Section was schelduled. Unfourtanlly during the procedure I was able to feel what was being done to my body and feeling my child move. It was a scary feeling but they were finally able to knock me out and contiune getting the baby out. My husband at this time was asked to leave the room after seeing the baby, and after the fact he told me what had happened. It took them hours after getting the baby out to finally wake me, and once I did the Doctor told me I had a Bandl's Ring. The information he gave me was as follows. Ishould not be able to have a VBAC due to a high chance of rupture. I will not be able to go past 36 weeks in a future pregnancy, and even though it's not guarenteed, he stated that the ring will most likely develop again next time. I do not know of anyone beyond forums that suffered from a Bandl's Ring, but the information I've found there is still scarce. Hoping time will tell as they may be able to find some more information on this condition in the future...

Sites that I have found include..

http://www.jrank.org/health/pages/30424/retraction-ring.html

http://womantowomancbe.wordpress.com/2009/11/03/bandls-ring/

http://www.babyworld.co.uk/faq/individualfaq.asp?Section=Labour+and+Birth&SubSection=Labour&query=&opt=&page=&question=2596

http://www.mothering.com/community/forum/thread/307869/need-info-about-bandl-s-ring-and-vbac


----------



## member234098 (Aug 3, 2002)

.


----------



## BexB (Nov 15, 2011)

Hi. I had a bandl's ring which resulted in a traumatic c section with a wonderful result because my son is alive and healthy.


----------



## tarnsnzl (Jan 25, 2012)

Hi there. I have a True Bandl's Ring - a condition so rare my surgeons were extremely excited when they opened me up for an emergency c-section (apparently they'd read about it but had never actually seen one in real life).

Basically what they told me is that you have two lots of uterine muscles. The top lot push the baby down. The bottom lot open up the cervix. Where these two groups of muscles meet is the Bandl's Ring and in my case when I go into labour rather than this band expanding (like 'normal' people), it gets tighter and tighter, pushing the uterus into an hourglass shape, resulting in uterine rupture.

This combined with the fact my pelvis is too small to fit a baby out, means 50 years ago we would have been gonners.

Anyway, having this condition means that for subsequent babies I have had to be booked in for an elective c-section a week before their due dates so I don't go into labour (I am not allowed to labour AT ALL), and should I happen to go into labour early, I have been advised to get to the hospital ASAP.

I have had two more children since my first. All elective c-section (obviously) and have no problems. In fact my last surgeon said that I have very little internal scar tissue. The scar tissue rubbing on the internal organs is the main reason why they try to not encourage any more than 4 c-sections but I do know someone who has had 7.

Recovery with each has been great - been up and out of bed the next morning even though hospitals here in New Zealand keep you in for 3 nights/4 days.

The only thing I've found is that a lot of midwives don't want to take you on because they don't really understand the condition (I've made a point of taking my medical records with me so they understand) and explaining it in basic terms like those above. I had to go through the hospital midwives for my last pregnancy as I moved towns.

Wishing you all the best and if you have any questions, don't hesitate to ask - I'm not a doctor lol, but I may be able to help.


----------



## MreeG (Mar 29, 2012)

I too have had a Bandl's retraction ring, I was told by the doctors and midwives at the time that I was the second person they had ever seen with one. I still don't fully understand exactly what it was and my child is nearly 3 now. Just really glad to read some of your views on it, as I was advised not to have anymore children. They ruptured my womb and then 6 days later I haemorrhaged and ended up having 3 units of blood. Haven't been able to get much info off of the Internet or from any doctors. I had to have an emergency c-section with my first child too after pushing for 4 hours and have now been told that I have a boy shaped pelvis and would never get a baby through it. Would love to hear whether anyone else has any views on this or knows anymore info.


----------



## Haelmoon (Oct 27, 2011)

Bandl's ring, as described above overs in labour. It is not a uterine anomaly, and it does not always recur. It depends what was the precipitating factor leading to a prolonged, but obstructed labour. Rarely, they can occur at the time of C-section, which is a bit of a nightmare, because it can become difficult to deliver the baby as the ring is just above the incision, and can trap the body after the head is out (or head if the baby is breech and the body is delivered).

The reason patients who have had a Bandl's ring are recommended to have repeat and early C-sections, is often there is significant trauma to the uterus in the attempt to safely deliver the baby. No infrequently, an inverted-T incision is made, which carries a much higher risk of rupture in subsequent pregnancies. Occasionally the vertical component is extended close to the uterine fundus, which is functionally a classical uterine incision. This carries a real risk of pre-labour rupture (1/3 of ruptures associated with classical incisions). That is often the reasons for a early, repeat c-section. However, if the ring was associated with non-recurring factors (advanced labour with fetus in a transverse position), and no vertical incision is made in the uterus, there would likely be a reasonable success rate for trial of labour in an attempt to VBAC.

It is true these are not seen commonly, mostly because obstructed labours are identified and addressed. This does not mean there is always a C-section, but rather contributing factors relating to labour dystocia can be addressed in a timely fashion, reducing the risk of harm to mom or babe.

To all moms describing there experiences, I understand it can be a very traumatic experience, physically and emotionally. I wish all of you the best and hope your road to recovery is smooth.


----------



## Sand1k (Jan 25, 2014)

Twenty-five years ago, I had a Bandl's Ring develop. My water was broken and after 12 hours of contractions two minutes apart and over four hours of pushing, I had an emergency C-section. At that time, it was explained to me that the ring formed from a fast, hard labor. The following months were difficult as they tested my baby for every possible thing. I was told all subsequent pregnancies would be C-sections. I only had the one. Twenty-five years later, she is beautiful and perfect!


----------



## BeccaOso (Feb 13, 2014)

Hi everyone! I just joined so I'm new, just so I could share my story too. I just had my baby on 1/31/14 and had developed Bandl's Ring after being in labor for 26 hours at home with a midwife. My water broke on Wednesday the 29th at 2:00pm. I labored all day and night and was dilating as scheduled, no signs of anything being abnormal. The next day, Thursday the 30th at around 4:00pm I started to feel the urge to push so I got in the water birth tub and after several attempts the midwife decided I try pushing in bed instead. When I moved to the bed and lay down she and my husband noticed an hourglass shape to my uterus. The midwife immediately recognized the condition of a possible Bandl's Ring, remembering her midwifery schooling, and decided we go to the hospital. I arrived at Kasier Hospital where they were all ready for me, no one had seen Bandl's Ring and some had never even heard of it, which was a bit scary. My contractions started getting worse. I decided to take the Epidural since they suggested I take it so I might rest after 26 hrs of labor. They also gave me a little Pitocin to regulate the uterus contractions. After that I slept, dilated to 10cm, and was able to push my baby out vaginally. I had a total of 36 hr labor. Everyone at Kasier told me that they see no reason why I can't have a vaginal home birth at my house next time. And my midwife said that she knows a couple of women that have had Bandl's Ring with no future occurance in other pregnancies. It's a pity that there isn't more info out there. I hope my experience helps someone. Apparently there's a 1 in 5 million chance anyone will get Bandl's Ring.


----------



## Babss (Feb 23, 2014)

In 1985, I was pregnant with my oldest daughter. At 33 weeks, my water broke and I went into labor. My contractions were 7 minutes apart for more than 24 hours - not terrible hard - I could talk through them. After a couple of days, they transferred me to the ward and put me on strict bed rest so that I could keep the baby inside me as long as possible. By that time, I didn't perceive any contractions. They were waiting for me to develop an infection before they took the baby out by C-section, because the longer inside me, the more mature her lungs would be. That happened on day 4 (from the time my water broke.) When the doctor opened me up, I heard him yell, "help me, for God's sake, help me get the baby out." He finally made a T-cut in my uterus (vertical, as well as horizontal) and got my daughter out. She was resuscitated right away and was fine. On the outside, there's only the usual, low horizontal incision near my pubic bone, but inside is this additional cut. I was told maybe one more baby, but a planned C-section and then no more because of likely uterine rupture with labor. That was fine with me as I had my second 4 years later at age 42. Having the preemie was so traumatic, even though my daughter was healthy, that I went to great lengths to try to avoid another preemie. I asked several consultant doctors what caused it and how to prevent it, but all I got were shoulder shrugs. (This particularly annoyed me while I was watching all these United Way ads saying "You can prevent premature births." Ha! What a joke! I was a saint during my pregnancy -ate well, no smoking or drinking. Was totally healthy.

I read the op report of my first pregnancy in which the doctor diagnosed Bandl's ring of the uterus. In those days, no internet, but I spent a great deal of time in the medical library looking it up in OB textbooks and Pubmed. (I'm a physical therapist.) The textbooks didn't even describe it. They said, "no one is ever barbaric enough anymore to let a mother stay in labor long enough for that to happen." It was quite difficult to even find a simple definition, but I finally did. My regular OB had NO IDEA what that was, and rebuked the doctor who delivered me for doing a C-section. That assured I was never going back to him. I went to a "high risk" OB specialist for my second pregnancy who also had no idea what it was. Fortunately for me, when I finally delivered my second by C-section (a week before my planned C-section) the operating doctor (the specialist I had gone to was on a boat in the San Juan Islands) not only knew what it was but said it was present at his own birth. I was grateful he was old enough to even know what it was. Second delivery no problem, full term. And it happened within a few hours of my water breaking and contractions starting so no Bandl's ring. However, my uterus did burst (an anticipated complication if I was allowed to go into labor at all because of that T cut in my uterus) just as he had peeled back my bladder, but he was ready to clean up right away, so no problems. Amazingly.

Today I read in the paper the following headline: "C-section guidelines urge waiting." They are advocating waiting to do C-sections for days after the mother goes into labor. There might be much more awareness of Bandl's ring in the near future, I suspect.


----------



## rhianjosh (Feb 25, 2014)

Quote:


> Originally Posted by *Cian'sMama*
> 
> Hi Mamas,
> 
> ...


Quote:


> Originally Posted by *Cian'sMama*
> 
> Hi Mamas,
> 
> ...


Hello I had it too my boy is 4 months now nearly finding it hard some days no One has ever seen it before only text book still haven't had a period and I'm Breast feedin so that could be why? Been on iron tabs but have stopped takin them still feel rotten though never met anyone who had heard Of it rhi x


----------



## sami87 (Mar 26, 2014)

Hi there fellow bandyl ring ladies!
I too had a bit of a scary experience with bandyls ring. Mine went unnoticed until the doctor actually got my baby out. I had no symptoms and no obvious signs during my pregnancy. No dint on my belly, nothing!

My waters broke, went to the hospital, no contractions, then they induced me with a tablet on the cervix, instant contractions, immense pain, got given the gas, had morphine and after 17 hours of severe pain and contractions that went for a minute then I had a minute break, they decided to give me an epidural. I was at that point 7cm dilated. I was so tired but felt relief. Even ate a sandwich!
30 mins later, midwife noticed babies vitals dropping, called the doctor.... He rushed back and within 15 Minutes I was on the operating theatre table. Lucky I had my epidural but a bit silly to of had a sandwich :-/
The doctor was amazed when he opened me up, did not alert me or my mum to anything because we were already stressed out enough.
Baby came out, it was a boy. But no cries, blue in colour - my mum blocked my vision of him as they revived him.
I saw him for 5 seconds. I kissed his head and off he went. I got stitched up and was waiting in recovery.
I never got the chance to hold him until 12 hours after the birth.
My doctor debriefed me on what went wrong.
I live in Australia so if you don't have private health care you go into the public health care. I went public but got a private patients care. They stuffed up so they provided me with the best of the best. I was moments away from the uterus rupturing and my baby dying.

Thank god for that midwife calling the doctor when she did!

I now have a 16 month old beautiful and healthy baby boy! He was born at 9pounds and like other stories that I have read, my pelvis was too small anyways and plus with this condition we seem to share, it has prevented me from having the "normal" way of birth experience.

THERE IS NOT ENOUGH INFORMATION OUT THERE AND ITS PATHETIC!
This condition has been around for years and years. Childbirth is a common occurrence! I wish there was more information.

I am now pregnant with my second child and only at the end of the first trimester. I have moved so my OB won't be treating me again and I am worried that the new doc won't have a clue!

I have a question for any of you ladies who have gone on to have your second baby,
Did you have to do anything differently this time. Was there any pain with the pregnancy?

Thankyou all for sharing your stories. And to those who have lost little ones, my heart goes out to you. ?


----------



## rhianjosh (Feb 25, 2014)

Quote:


> Originally Posted by *Cian'sMama*
> 
> Hi Mamas,
> 
> ...


Hello I had it too my boy is 4 months now nearly finding it hard some days no One has ever seen it before only text book still haven't had a period and I'm Breast feedin so that could be why? Been on iron tabs but have stopped takin them still feel rotten though never met anyone who had heard


----------



## justanothersahm (Apr 9, 2014)

I know this is an old thread, but as most of you have said (and noticed) there isn't much information so you ladies are all I have. I had my son 16 months ago.

I never had braxton hicks contractions or false labor, but I did have high blood pressure the last three weeks of my pregnancy and was put on bedrest. My labor started 2 weeks before my due date by my water breaking, immediately my contractions were 2-3 minutes apart. My midwife/OB team had decided it was okay for me to labor at home with my doula as long as we checked my blood pressure regularly and came in to the hospital if it went too high. I labored at home for 8 hours and then went to the hospital (45 minute drive), I dilated from 4cm to 9cm in thirty minutes once I got to the hospital and was pushing within an hour of arriving. And then I pushed, and pushed, and pushed. After 4 hours I decided I was exhausted, we had tried every position imaginable and I was starting to run a slight fever, so off to a c-section I went. During the c-section I wasn't really paying attention to the surgeons, however, I did realize that at the start I had one surgeon and then a few minutes in I had two surgeons (I figured it was a slow day). Our son was delivered, I got to kiss his nose and then he was wisked away. He had breathing problems, breathing 100 breaths per minute and he wasn't brought to me or off oxygen until he was 20 hours old.

A few weeks later at my postpartum appointment with my midwife I asked her what happened, why did I have to have a c-section and could I try for a VBAC in the future. She looked at my file and said, "Oh, you were the one with the Bandl's ring" and said a VBAC would not be possible.

I have just found out I am pregnant with Baby #2, whose due date is on my son's 2nd birthday. I would love to hear from any of you what your pregnancy after the Bandl's ring was like. Did you have to have a c-section early, any pregnancy complications?


----------



## rhianjosh (Feb 25, 2014)

I would opt for a c section if I was you just incase they can't detect it until you are in labour best be safe , I'm too scared to have anymore I think still traumatized from the birth 6 months ago , wish I could do something to make people aware of this happening I was so lucky I had a good doc in a hospital x wishing you the best of luck in your 2 nd birth rhi x


----------



## marymidwife (Jul 31, 2014)

*Two types of rings called 'Bandle's ring'*

Hi,

I recently started looking into this and like, you, couldn't find much on the internet. I'm also assuming that is because Bandle's ring doesn't happen as much now due to the time limits on normal labor.

I have looked it up in _William's Obstetrics_ and also found a more thorough description in _Oxorn-Foote Human Labor & Birth_ and most of the discussion below comes from that book.

Oxorn-Foote calls the two types _Pathologic Constriction Rings_ and _Pathologic Retraction Rings. 
_
*Pathologic Retraction rings* happen because of obstructed labor. The baby is in a bad position or is just too big to get through the pelvis. In normal labor the upper part of the uterus gets thicker and thicker as labor progresses. The lower segment - which is really just the cervix as it opens up - gets thinner and thinner. When labor goes on and on without the baby being able to get through the pelvis, the lower segment can thin so much that a doctor can see through it during a c-section OR it can rupture. 
Differential Diagnosis of Pathologic Retraction Ring: The ring is always located at the junction of the upper and lower uterine segments; The muscle of the uterus is thicker above the ring than below it; the uterus above the ring is hard; The round ligaments (on the sides of the uterus) are tense and stand out; This type of ring usually occurs late during the pushing stage of labor; The ring gradually rises in the abdomen; The presenting part is jammed into the pelvis; Part of the baby may be below the ring; The ring is caused by an obstruction; the mother's condition is poor; the uterus is contracting well, or too well.

*Constriction Rings* may happen when the uterus is 'colicky'. That means the contractions are not coming regularly, or effectively with the baby not moving down and pain is present all the time, not just during contractions. It can also happen after failed forceps delivery (probably when they did high forceps deliveries) or from other interuterine manipulations. This type of ring tightens around the baby and prevents it from moving down. Sometimes a second twin is affected. Anesthesia can relax these rings. Constriction rings (as opposed to pathologic retraction rings) never lead to uterine rupture, but they can strangle the baby by cutting off the blood supply.
Differential Diagnosis of Constriction Ring: You can feel the ring on the mom's abdomen; The baby's head does not move down during a contraction; The baby's head is loose in the pelvis during and between contractions; The cervix is not tight against the baby's head; If a finger is placed between the cervix and the baby's head the increased pressure during a strong contraction will be slight on the finger; Because the cervix is so lax a hand can pass through it and the ring can be felt inside the uterus (I'm so glad no one ever did that to me!); The ring can occur on any part of the uterus; The muscle at the ring is thicker than it is above the ring or below it; The uterus above the ring is relaxed and not tender; This type of ring can happen at any stage of labor; The baby may be mostly or completely above the ring; the mother's condition is generally good.

I thing that realizing there are two types of rings, both often referred to as Bandle's rings makes it all more understandable.

I didn't see that either book mentioned that the condition repeated itself in future pregnancies.


----------

