Dr. Anindya Das
Obstetrics and Gynecology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
A couple of days before, I found out that I was pregnant. According to the first day of my last menstrual period, I am about four and a half weeks pregnant. This is my fourth pregnancy. I had an ectopic pregnancy for four years. Then gave birth after a year through emergency cesarean and delivered another baby through cesarean after 15 months. After my second baby, my doctor advised me not to get pregnant for a minimum of 18 months to 2 years. She said that my uterine wall was very thin. It has been almost 18 months since my last cesarean. I am now confused about whether to continue with the pregnancy or not. I spoke to my GP, and she said it is all up to me, but there is a risk. What should I do now?
Hi,
Welcome to icliniq.com.
I think your GP has guided you correctly. Abortion can be associated with complications, some of which may be major. Your gynecologist informed you about your weak uterine scar. So, a continuation of pregnancy can be risky as well. In my opinion, you should consult your gynecologist who had done your cesarean section. Then, after understanding every advantage and disadvantage, you take the decision.
Patient's Query
Hi doctor,
Thanks for your reply. The problem is that there is no way of getting in touch with the gynecologist because it was done at a public hospital. The doctor who was on duty on that particular day performed the cesarean. I went to my GP again, and she said it is a risk to continue the pregnancy. I want to get an opinion from you. What are the risks to me and the baby in continuing the pregnancy?
Hi,
Welcome back to icliniq.com.
The main risk we fear in pregnancy with the previous uterine scar is uterine rupture. The incidence of uterine rupture was more previously, but the incidence has come down with improved cesarean techniques and improved infection prevention. Rupture of the uterus is a life-threatening condition and requires emergency medical attention and surgery. If the rupture occurs, then the possibility of survival of the baby is significantly less. With time the chance of rupture decreases but does not vanish. In this type of pregnancy, the chances of bleeding during pregnancy are another possible complication. But, frankly speaking, we see more mothers with previous cesarean section continuing their pregnancy without complications than with complications. It is challenging to comment on your case without a physical examination.
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Obstetrics and Gynecology
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