I’m 42 years old and had identical twin boys last summer, conceived naturally. The pregnancy was unremarkable and there was no TTTS.
The babies came 6.5 weeks early and were delivered by emergency caesarean (low transverse cut). The labour notes said that I had a poorly formed lower uterine segment and ragged membranes. I lost just over a litre of blood, with the increased blood loss attributed to the poorly formed lower uterine segment, but did not need a transfusion.
I would like to try for another baby and am thinking of VBAC but am concerned about a few things.
From what I can make out, a poorly formed lower uterine segment means it is thicker than it should be. The surgeon double stitched the uterus after the C-section.
My questions are:
Q1 Is it a good thing that it was thicker than it should have been in that there would be more uterus to stitch together and therefore give a stronger “seam”?
Q2 Does having a poorly formed lower uterine segment in a previous pregnancy mean that you will have the same in subsequent pregnancies?
Q3 What problems could this cause?
My twins came exactly 1 week after my little girl’s first birthday. She was an uncomplicated vaginal birth and came very quickly, I went from 2-3cm to 10cm in an hour and was only pushing for 7 mins before she was born. Contractions were very very strong and coming every 20 seconds. If I do try again, the inter-delivery period would be approximately 22 months and I would be 44 years old.
If I did try for another baby and wanted to deliver vaginally then:
Q4 Would the fact that labour would be likely to be very quick and intense with virtually no break between contractions mean that the uterus would be under more pressure than an average length labour where the contractions are a bit more spaced out?
Q5 Would uterine rupture be more likely or less likely with a quick labour given that the rate of contractions acting on the uterus would be a lot faster than an average pregnancy but the overall time period would be a lot shorter?