Post-hysterectomy Pregnancy

Introduction:

A hysterectomy means the surgical removal of the uterus. The occurrence of pregnancy after the hysterectomy procedure is very rare. The fertilized egg implants in other organs like fallopian tubes (they are two tubes present on either side of the uterus). It is possible but rare to conceive if the cervix is not removed. The hysterectomy is suggested as a birth control procedure. The chances of conceiving after this procedure are very less. A hysterectomy is a common procedure.

What Does a Hysterectomy Procedure Mean?

The hysterectomy procedure is the surgical removal of the uterus and cervix. The other organs, like fallopian tubes and ovaries, are also removed depending on the reason for a hysterectomy. The fetus grows and develops in the uterus. The uterus lining is expelled during menstrual periods. There is an incapability to get pregnant and have menstrual periods due to the absence of the uterus.

What Are the Different Types of Hysterectomies?

The different types of hysterectomy procedures are as follows:

• Total Hysterectomy Procedure: Total hysterectomy means the removal of the cervix and uterus, but the ovaries are not removed.

• Supracervical Hysterectomy Procedure: Supracervical hysterectomy means removing the upper portion of the uterus, and the cervix is left in the body.

• Total Hysterectomy Procedure With Bilateral Salpingo-Oophorectomy: This procedure includes uterus removal along with the cervix, fallopian tube removal (salpingectomy), and ovary removal (oophorectomy).

• Radical Hysterectomy With Bilateral Salpingo-Oophorectomy: This procedure includes uterus removal along with the cervix, fallopian tubes removal (salpingectomy), and ovaries removal (oophorectomy). Along with this, the upper part of the vagina and some surrounding tissue and lymph nodes. This is done in case of cancers.

The hysterectomy procedure is performed through an incision in the abdomen called abdominal hysteroscopy. The hysterectomy procedure is performed through an incision in the vagina called a vaginal hysterectomy. The laparoscopic hysterectomy procedure is also done with the help of a laparoscope (a tiny tube inserted through the vagina and a small camera attached to visualize the internal organs) and with the help of a robot-assisted laparoscopic hysterectomy procedure.

What Is the Reason for the Hysterectomy Procedure?

The reason for the hysterectomy procedure is as follows:

• Bleeding: Uncontrolled and heavy vaginal bleeding is not stopped with other treatment procedures. Other treatment methods fail to control severe pain during menstrual periods.

• Uterine Fibroids: The presence of benign (noncancerous) tumors called leiomyomas or uterine fibroids. Elevated pelvic pain is uncontrolled by other treatment methods.

• Uterine Prolapse: There is urinary incontinence and difficulty with bowel movements due to uterine prolapse (the uterus goes down into the vaginal canal because of the weakened support of muscles).

• Cancers: Another reason for a hysterectomy is cervical cancer. Uterine cancer is another reason.

• Uterus Hyperplasia: The uterus lining is endometrium and becomes abnormally thick because of many calls.

• Endometrial Polyp: The benign (noncancerous) growths attached to the inner wall of the uterus (womb).

• Adenomyosis: In this condition, the endometrium, which lines the uterus, breaks through the muscle wall of the uterus.

What Are the Side Effects of the Hysterectomy Procedure?

• Pain in the pelvis and abdomen. Advised painkillers to subside the pain.

• There is redness, bruising, and swelling in abdominal hysterectomy cases near the incision area.

• Around the abdominal incision, there has been numbness for some months.

• Recommend using sanitary pads and not tampons for severe vaginal bleeding.

• There is bloating and gas formation in the stomach for a few days. Exercise and warm compress help with such signs.

• Constipation.

• Problems with the urinary bladder.

• There are no longer menstrual periods due to the absence of the uterus, which is a permanent alteration.

• If the ovaries are removed, then menopause occurs. The signs include vaginal dryness, sleep difficulty, mood swings, and stoppage of periods.

• There are alterations in sexual feelings.

• There is a feeling of sadness.

• Elevated risk of other health conditions like osteoporosis (new bone tissue does not form with old bone tissue removal, and the bones become weak and brittle) and heart disease.

• Unable to carry a pregnancy for nine months as the uterus is absent, which is essential for a viable pregnancy.

• Depression over the loss of fertility and changes in their body.

What Are the Chances of Conceiving After a Hysterectomy?

Women conceive after a hysterectomy procedure if the fallopian tubes and ovaries are intact, but it is rare. After the hysterectomy procedure, if the woman is fertile, embryo formation is likely. Due to the lack of a uterus where the embryo implants in normal cases, the embryo attaches and develops in the fallopian tubes. The pregnancy is referred to as ectopic, which is a serious medical emergency. The fallopian tubes are narrow passages and cannot accommodate the growing fetus. Therefore can lead to the rupture of the fallopian tubes and heavy blood loss. An ectopic pregnancy is not normal, and the baby after the delivery is not healthy. As soon as the ectopic pregnancy is detected, efforts must be made to terminate the pregnancy.

The signs of ectopic pregnancy are as follows:

• Severe cramping pain on one side of the abdomen.

• Sudden spotting from the vagina.

• Nausea and vomiting.

• Dizziness.

• Fatigue.

• Vaginal bleeding.

• Neck pain.

• Pain in shoulder and rectum.

What Are the Other Methods to Have a Baby After a Hysterectomy?

The other methods to have a baby after a hysterectomy are as follows:

• Surrogacy: After the surgical removal of the uterus, it does not mean that the ovaries cannot carry out normal functions. Hence the eggs discharged by the ovaries are used for in-vitro fertilization. Invitro fertilization means the fusion of egg and sperm in a test tube. After this, the fertilized egg is transported into the surrogate for further embryo development. The fertilized egg cannot be placed in women after a hysterectomy as the uterus is absent. Surrogacy helps to have genetically related children. Also, surrogacy is not permitted in every country.

• Uterus Transplantation: After the hysterectomy procedure and recovery. The woman can opt for uterus transplantation. Uterus transplantation is a highly complex surgical procedure; the donor's healthy uterus is transplanted to the woman after a hysterectomy. This procedure is still in the experimental phase. There are risks to both the donor and recipient.

• Can consider adoption in such cases.

Conclusion:

Even if conceiving after the hysterectomy procedure is possible, the pregnancy is not viable and causes severe complications. Having a baby after a hysterectomy is highly uncommon, but it can happen. This can result in an ectopic pregnancy, which can be seriously dangerous. When a fertilized egg implants outside of the uterus, this happens. Hence better to terminate such pregnancies and opt for other methods of giving birth to a baby.