In plain words
A hysterotomy is the cut a surgeon makes in the uterus during a . Most are made low on the uterus, across the lower segment. Some are made higher, which changes the scar. Through this cut, the baby is delivered. The surgeon then closes the uterus in layers. The hysterotomy is the reason a cesarean leaves a scar on the uterus, and that scar matters in later pregnancies. Each cesarean adds a scar. The scar can affect where the placenta attaches and how the uterus handles the next labor. Prenatal visits often ask about the type of incision. The term names the cut itself, not the whole operation. An obstetric team can explain a person's own scar from her operative note.
The deeper version
Most hysterotomies are low transverse incisions in the lower uterine segment. Classical vertical incisions are used in some preterm, transverse-lie, or emergency situations, and they carry higher rupture risk in a future labor. Scar healing depends on layer closure and the thickness of the remaining . Each prior hysterotomy leaves a scar with a thinned . Implantation over the scar predisposes to and to , in which chorionic villi invade the myometrium. Incidence rises steeply with the number of prior cesareans (Silver and colleagues, Obstetrics and Gynecology, 2006). Controversy persists over optimal closure technique and over whether niche formation at the scar affects later fertility or menstrual symptoms.
Where it comes up
- Planning a cesareanGetting Ready for Birth
- VBAC: birth after a cesareanGetting Ready for Birth
- What happens in a cesareanBirth and the First Days
What mothers here say about hysterotomy
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Sources
- Silver RM et al. — Maternal morbidity associated with multiple repeat cesarean deliveries. Obstetrics and Gynecology, 2006
- American College of Obstetricians and Gynecologists — Practice Bulletin 205: Vaginal Birth After Cesarean Delivery, 2019