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  1. #1

    VBAC and Bicornuate Uterus

    Hello! I have a doula client who is interested in having a VBAC in spite of having a bicornuate uterus. I have been told by another birth professional that the odds of placental abruption are significantly higher in women with bicornuate uterus. What are your thoughts on this?

  2. #2
    aussiemidwife's Avatar
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    Feb 2010
    Sydney, Australia
    This is a really interesting question - I had to do some research as it is not a question I've been asked before. I did my usual searches using pubmed, medline and other databases that did not reveal any research. I found a post on VBAC and Bicornuate Uterus on the Lamaze forum by well known obstetric researcher Henci Goer - Henci found two studies that contradicted each other - one showed an increase risk in uterine rupture and the other found a decrease in the risk of uterine rupture for women with a bicornuate uterus having a VBAC. Needless to say that there is a distinct lack of research in this area to guide practice. I was reassured by the study in the American Journal of Obstetric and Gynaecology (Ref: 2007 Jun;196(6):537.e1-537.e11) that showed that VBAC for women with a bicornuate uterus did not increase scar rupture. This study however is retrospective (i.e. looking back on what happened). This type of study is not as reliable as a prospective study design.
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  3. #3
    Thank you for taking the time to do some research for me. Your results are pretty similar to my own. I assume the lack of research is related to the fact that this is a somewhat rare condition. This is the second mother I have worked with that suffered from this particular abnormality however. The first mother chose to cesareans, though she did find a practitioner who was willing to give her a trial of labor. Until recently, I though the biggest issue was that the babies of women with bicorunate uteri are often breech. I do wonder what part the severity of the malformation plays.

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