With the relaxation of the two child policy, many families are catching up with the trend and actively giving birth to a second child, including many women with scarred uteruses. This phenomenon is a challenge for obstetricians and gynecologists. Few people know the reason here, which is that scarred uterus can rupture at any time, affecting delivery! This is undoubtedly a "time bomb" that endangers the health of both mother and baby for postpartum women.
What is a scarred uterus? As the name suggests, a scarred uterus refers to a uterus with scars left on it after injury. The main affected population is women who have given birth and have undergone cesarean section. In clinical practice, most patients do not have obvious characteristics, but they may also have symptoms such as vaginal bleeding and uterine rupture.
Due to various reasons, the cesarean section rate in China has always been relatively high, with some hospitals even having a cesarean section rate of around 85%. Some women may be found to have scarred uterus after giving birth to their first cesarean section baby. Even if there is a plan to have a second child at this time, professional obstetricians and gynecologists will recommend delaying pregnancy appropriately. Because mothers with scarred uterus have a much higher risk of pregnancy and childbirth compared to ordinary mothers, obstetricians and gynecologists generally recommend that patients use contraception for two years after cesarean section. So what are the hazards of scarred uterus pregnancy?
The risk of uterine rupture is high
Scared uterus indicates that the healing effect of the anterior wall of the uterus and other parts is not good, resulting in some parts of the uterine wall being thicker and some parts being thinner, and lacking elasticity. If pregnancy starts too early, it will cause adverse stimulation to the uterus due to embryo implantation and placental growth and development, thereby increasing the risk of uterine rupture, especially in the late stages of pregnancy, when the fetus gradually grows, the pressure in the uterine cavity increases, muscle fibers elongate, and scars rupture. Most ruptures occur during childbirth, with a few occurring in the mid to late stages of pregnancy before delivery. Once a scar or uterine rupture occurs in a second child, both mother and child are particularly at risk.
One of the hazards of uterine scar pregnancy is that it can easily lead to dangerous placenta previa. After pregnancy, women with uterine scars may gradually approach scarred areas such as the anterior wall of the uterus as the embryo continues to grow, which may lead to the possibility of pre implantation of the embryonic disc. If not treated effectively and promptly, it may affect the safety of the fetus and cause adverse stimulation to pregnant women.
Postpartum hemorrhage is prone to occur in women with scarred uterus. Although early re pregnancy can lead to normal delivery, it can also easily cause uterine tears and symptoms of postpartum hemorrhage, especially intra-abdominal hemorrhage, which is most likely to occur and often requires hysterectomy surgery to recover. That's why, in order to ensure the smooth progress of another pregnancy, it's best to wait until the uterine scar is repaired before considering pregnancy.
So even for patients with fertility requirements, doctors will recommend that the time interval for re pregnancy after cesarean section should not be less than two years, and the healing of uterine scars should be evaluated before re pregnancy. Imaging examinations should be conducted in early pregnancy to assess the position of the gestational sac. If the thickness of the lower segment of the uterine anterior wall muscle layer is less than 3mm in patients with scarred uterus after cesarean section, it is recommended to undergo diverticulum repair surgery before choosing pregnancy. If a high-risk pregnant woman with a scarred uterus becomes pregnant again, regular ultrasound examinations should be performed to confirm the attachment site of the embryo, diagnose whether it is a scarred pregnancy as early as possible, actively treat it after diagnosis, and strengthen pregnancy management. Because most scarred pregnancies are dangerous, once diagnosed with a scarred uterus pregnancy, termination of pregnancy is often recommended.
Summary
Therefore, it is recommended that women with scarred uterus go to a regular hospital for pre pregnancy examination to see the recovery of scars and evaluate whether the current uterine condition is suitable for another pregnancy. After pregnancy, in the early stages of pregnancy, it is necessary to use ultrasound to check the position of the gestational sac, screen for scar pregnancy, and do prenatal check ups during pregnancy to strive for a smooth transition.