Bandl's Ring and emergency section first time - any chance of a 'normal' delivery this time??

[Catla]

Just found out we're preganant with baby no.2! DD is 11 months old and was born by emergency C-section after a 20 hour labour. I was told that I had something called Bandl's Ring (or Bandels/Bandals don't know!) and I'm finding it really difficult to find any further information. i'm meeting with the consultant at 16 weeks and would really like to know whether I do have the option of VBAC and what the risks may be before going to see her in case I'm told it's elective section and that's it - i'd like to have a bit more information myself first. Anyone know any more about this and/or anyone had a VBAC with Bandl's Ring?? Would appreciate any information/advice,
Catla xx

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If it was a true Bandls ring it is a very rare complication that usually precedes a ruptured uterus which is an obstetric emergency. I expect that they would recommend an elective cs, but it may depend on the original birth, the size and position of the baby, how long it went on for etc, and they may be happy to 'let' you have a short trial of labour. Good luck.

I'm very interested in this!
I had Bandl's Ring in 1st pregnancy too, wasn't told very much by the hospital at the time and not seeing consultant till 33 weeks (I am 27 weeks at the mo).

Not very much on the internet about this condition apart from that its quite rare. I don't think the condition was spotted until I was opened up for emergency cs and the removal of my ds took an awfully long time.
Any information/advice gratefully received!

ditto cat2010, I don't think they can tell until they open you up. Maxbear, it is very rare and my uterus was on the verge of rupturing and I'm not sure whether the weakness will remain or not. I have had differing information about whether it will occur though I am told it is made a ot worse with syntocin drip which I was put on after 10 hours in labour when my contractions began to ease off. Just out of interest cat2010, were you pun on syntocin?? I've got the appointment with the consultant in 2 weeks now but I would be very intested what you're told too - contact me direct if you prefer? xx

Catla, I have seen the consultant and results encouraging. She had read my previous file in some detail before talking to me. Like you, I had syntocin (waters broke, failure to progress etc) and it didn't agree with me or ds at all!

Consultant recommends VBAC if labour starts naturally, she believes my condition was a one off. Some people are at higher risk due to very narrow hips etc and others its just a symptom of the individual pregnancy. My hips are more than adequate!

She did say it was down to choice but VBAC less risk than caesarean irrespective of having been through a CS once before and VBAC has also has advantages in terms of recovery time.

However, she did say that if I hadn't gone into labour naturally by 40+7, she would want to rediscuss with me as induction changed the odds. It would still be a personal choice and she would be happy to try VBAC but it could end up in Emergency CS which is slightly riskier, so if it comes to induction then planned CS may be a more sensible option.

She was very helpful and supportive and I came out convinced VBAC was the way forward (I had been leaning towards CS before). Hope this helps! Let me know if you need any more info.

Good luck with your decision. x

thanks very much indeed, it will be good to go to my appointment with the point of view of another consultant in mind - I am seeing her next Wednesday. I am hoping she will say that VBAC will be possible (I should have no issue with hips either!) even though in some ways section would make planning easier having an 1 year old and no family assistance round but at the end of the day it's better for baby and better for me if we can try and deliver naturally.

I know this is such an old post but was very interested in the outcome of your birth. I just had a birth with a contraction band and am very concerned about future pregnancies and if a vaginal birth is possible.

I'd be interested to hear outcomes too. I had a bandl's ring with my first. Newly pregnant and looking for information/reassurance. Hopefully I'll be able to update you on my experience though Kaitlinsara

Im replying to this old post with my experience because of the 2 more recent postings...
My first was born in 2016, emergency CS after failure to descend. Once I was opened up they saw why: Bandl's rings. I didn't follow up with questions about this but was told at the time future pregnancies would require CS. This was disappointing as I never wanted a CS but at this point I did understand it was medically necessary and had I not finally consented one or both of our lives may have been at risk, though we did not get to that point, thank God. January of 2019 I found I was pregnant again, finally. I saw a team of doctors, it was whoever was on clinic duty that i saw with each visit and I saw the whole team over the could my pregnancy then post delivery - same team I s aw with my first. At one visit the doc came in as stated excitedly that I had "an interesting OB history". I asked why, as I didn't think anything particularly interesting had ever happened in my medical history. She mentioned the "rare" complication that let to my CS, I acknowledged I understood it to mean I would require a CS with this one, to, and we completed our visit. At this pi still wasn't asking any further questions ( I didn't want to know, honestly, in case the condition was something more serious than simply requiring a CS, I didn't want to panic). I was also hearing the docs say "banded contractions" so when I even mentioned it to others I wasn't repeating it correctly, which wasn't a problem until my water broke at 37 weeks, a week and a half before my scheduled CS, and I went to the hospital at 1am and was trying to explain this to the charge nurse as she was trying to figure out why I was insisting I could not attempt VBAC. She said she'd never heard of it and didn't see anything my medical records. I waited for the OR for a little over an hour and by the time the same nurse was prepping me for surgery she somehow did find the information and understood my situation and the need for a CS, especially since I was early (apparently if you go early there is hightened risk).

Everything went well with this delivery, but while I was still on the table my doc said had I gone much longer my uterus would have ruptured. And by "much longer" she meant hours to a few days, that's how thin my lower uterus had gotten. Didn't help my boy was already large (8lbs10oz at birth). They had to "repair" my uterus and said I could still have more children BUT I would not be allowed to go beyond 37 weeks, due to risk of uterine rupture.

This was 3 weeks ago. I just got curious and begin searching Google, which just enlightened me to the actual name/spelling of this condition and led me here. My limited research, coupled with my hindsight of personal experience, is this: while a rare condition (0.02% is a stat I saw) it is thought that number may be wildly underestimated (not sure why, perhaps docs not diagnosing/recognizing it or just an increase in the condition itself?). It presents with "failure to descend" and the baby gets stuck which could lead to much more severe issues if a CS isn't performed relatively soon after the failure to descend is recognized. It is the result of the lower half of the uterus having complications which then causes it to thin, which can lead to a ruptured uterus (which is as bad as it sounds, especially if you're not already in the hospital on the operating table). To my understanding, once diagnosed the condition does not go away or improve, once you have it you have it. I would love to know of the original poster and respondents were successful with VBACs because that would either mean they didn't have Bandl's in the first place OR my last assumption isn't true. Yes, I have a 3 week old in my arms right now but I'm already wondering if I should be considering a 3rd child or if it is too risky, given my condition.

Other curiosities I have, considering there is so little information out there, is this genetic? No one in my direlct line has has a CS or other serious complications I doubt it, but still curious. Is age a factor? I was 34 1/2 with my 1st, 38 now. Is there a higher risk of future miscarriage or just the risk of ruptured uterus near the end or pregnancy? Is preterm labor common? (Not that my 37w1d delivery was considered preterm, but he was even earlier than my 38w1d first baby, would a 3rd be even earlier?) Any other questions anyone else has? Any answers, or even just thoughtful speculation based on your experience?

Following this as I'm terrified of baby no.2 after EMCS with bandls ring with my first at the beginning of June. @DLM63116 thank you for posting!!

Brief follow up: at my 6 week post delivery check up, I asked my OB if, due to how thinned my uterus got with #2 and how big her got plus how early he insisted on arriving, would they advise against a 3rd baby? She said there is nothing that would cause concern with conceiving and carrying a 3rd baby, they just advise another C-section. The Bandl's rings, to their understanding, only effects delivery.

I find it funny they can still only "advise" a C-section and it is still considered "voluntary" if I were to schedule one. But I think unless it's "emergency" it's "voluntary" - no middle ground. (I'm in the US, by the way, so requirements and even recommendations may be different not only from the UK but even between other US states. I'm in St. Louis, MO).

Hi everyone! Been looking for a updated post on bandls ring for a while!
I had my daughter 10 years ago.. got to 10cms and on first push womb twisted. When they opened me I also had bandls ring. I’m pregnant now, currently 33 weeks have only seen consultant once who has said its up to me whether I opt for a cs or try for a Vbac. However I’m having a scan next week to see how big baby is which will help to determine my decision... consultant says if I opt for cs they won’t give me one till 39 weeks...
I really don’t understand bandls ring.. midwife knows nothing on it. When I originally told her I had bandls ring in previous labour she stated ‘oh you must have that wrong o highly doubt it’

I just want to know what the chances are of it happening again! :( x

Rphoenix03, I was originally supposed to have a 39w C-section, baby size in late term scans pushed it into 38 weeks, then baby came right at 36 weeks. My untrained opinion is you're OK unless the baby is now measuring large. My future advice on a 37 week delivery is because of the thinned uterus... Which often goes with Bandl's, but until it occurs they can't plan for it. Just be hyper aware of what your body and your baby is telling you, especially if those around you aren't as concerned. It's not their fault, this isn't talked about. Even my ER nurse didn't know what it was until I was there for an hour (she either found it in my chart or looked it up) - once she did, she kicked it into high gear!

Good luck! Nothing to seriously worry about until labor beginnings, though, as far as I understand it!

I also had Bendals ring. Emergency c-section. 1st child Almost lost my boy. Very rare, most likely to reoccur. Opted for csection with 2nd early delivery and glad I did bendals ring was tighter and thicker 2nd time. Would not chance a 3rd.

How did you make out?

I had my first baby Dec 2023 at 43+ 4 weeks. She was 10.8lbs. My midwives think I had a Bandyl’s ring that developed in the last few hours of what was an 8 day—yes, EIGHT DAY— labor. Because she had already descended so far down and her heartbeat was strong, they believed I could push her out quickly and safely and so we did. I’m saying all this because supposedly I completed a vaginal delivery with a Bandyl’s Ring.

Has anyone else done this? Had anyone had a vaginal delivery after having a previous CS because of a Bandyl’s ring? I want future children and would love to deliver vaginally again if possible! I wish the internet had more info about this.

also, many of you are saying they had to cut into you to even find out about the Bandyl’s Ring. From what I know that Bandyl’s ring is obvious because your baby bump because two bumps suddenly do to the constricted uterus. So it’s possible to had the Bandyl’s ring but not even see it until you have a c-section?

Just a thank you for all the stories of second pregnancies following Bandl's ring. After a 42 hour labour including induction in 2023 I had an emergency CS where it was discovered I had Bandl's ring. Had to have a slightly extended incision and there were a few tense minutes in the OR but otherwise we were very lucky considering some of the other experiences and outcomes I see online.

I'm with a different consultant this time (currently 23 weeks) and while he would support my decision to try for a VBAC, assuming I didn't go into prolonged labour and things moved quickly, he has recommended an elective section. We've decided to go with that as Bandl's Ring seems to be so rare that little is definitively known about it in terms of reoccurance etc and I wouldn't forgive myself if something went wrong that we could have avoided.

That said, I have a phobia of CS's (pre-existing prior to my last) and so keep reading and rereading on the internet to keep convincing myself we're making the right call on this. I believe my consultant is thinking about 38/38.5 weeks for timing for the CS.

Yes, I would agree playing it safe is best. From what I've read online, Bandls's is not considered by all physiciana to be an ever present occurrence, but can happen randomly in some pregnancies and not others for the same women. My own OB team is of the belief once you have it, you always have it. I had it with my first (water broke in its own 37 week zero days) as I probably stayed above in a previous post. My 2nd (3 years later, as I was also advised to wait and be certain the uterus had healed even moreso than just a C-section) also broke at 37 weeks when we had a planned section at 38 weeks and the admitting nurse brushed off my insistence of getting into an OR as soon as possible until she finally read my notes and suddenly she had a sense of urgency, too. This baby actually ruptured my rapidly thinning uterus as the doctor was cutting down. He met the doc, not the other way around. Luckily it was all such quick timing there were no complications after that. Again I was told I should wait more than an year for my uterus to fully heal - from the thinning moreso than the section scar. Now by boys at 8 and 5 and I'm 20 weeks along. Very first appointment my OB said we will plan for 37 weeks his time after the timing (and healthy development) of the first two. Oh, the 2nd also began to grow rapidly after 30 weeks and had he stayed in 40 weeks I would have had a baby pushing 10 pounds. Instead I had a 37 week baby just under 9. That certainly didn't play well with the Bandls thinning the uterus once my water broke.

I'll report back how this delivery goes. 2 data points don't make a pattern, but my uterus thinned much more rapidly with my 2nd than my first. That is the bigger concern with Bandls than just the failure to descend.... If they don't descend they're going to get out one way or another. So, I expect to be posting some time after Valentine's Day 2025 with an update on baby #3.

To my experience and understanding Bandls is not obvious from the outside and does not even become an issue until labor/water breaks. My OB has told me that the rings don't present until contractions start. Until then it's a non-issue. Labor/delivery is the only time it can be detected. That said, here does not seem to be much consensus from physicians as the condition is barely diagnosed and the window is too small to study and not something detectable by ultrasound, only direct observation with surgery. Still so little information out there - honestly this thread has more information than anything I've found on a medical site!