Danger of pregnancy at the old caesarean section

Pregnancy at the old caesarean section is a dangerous pregnancy complication. If not detected and treated promptly, it can cause bleeding, uterine rupture, hysterectomy, and even endanger the patient's life.

Pregnancy at the old incision is a form of nesting in the wrong position of the egg. After being fertilized, the egg usually moves to the bottom of the uterus to implant, because this is the place where the fascia is thick enough for the fetus to grow and develop safely. For some reason, the egg implants and develops into a gestational sac at the isthmus of the uterus, where there was a cesarean section scar from a previous birth. The developing fetus will attach to the uterine muscle at the isthmus of the uterus, this is a location with a thin layer of muscle so the placental spines can cause bladder wall compression and bladder damage. On the other hand, at the isthmus of the uterus, there are scars from the previous surgery to give birth, these scar tissues are not as elastic as healthy tissues, so it is easy to tear the incision causing miscarriage.

Pregnancy at the old incision is listed in the list of dangerous pregnancy complications. The disease is rare, only 1% of women experience this complication. People who are pregnant at the old incision may face the following dangerous pregnancy risks:
Hemorrhage if spontaneous abortion Uterine rupture due to placental puncture of the uterus at the old incision Mandatory hysterectomy Dangerous to life due to excessive blood loss if not detected and treated promptly People who are pregnant at the old caesarean section cannot keep the fetus, due to the increasing size of the fetus during the development process, the risk of rupture uterus is very high.

All women who have had a cesarean section, when pregnant again need to check with ultrasound to determine the position of the fetus. In case of abnormal findings, doppler ultrasound and consultations will help find ways to minimize the risk of complications. If the fetus is located in an abnormal position, especially close to the old incision, the abortion should be performed as soon as possible to avoid complications that occur when the size of the fetus is larger.
In addition, pregnant women at the old caesarean section absolutely do not arbitrarily use drugs that cause miscarriage, because it can cause uterine rupture leading to bleeding that is life-threatening.

Women with confirmed pregnancy at the old caesarean section need to undergo surgical removal of the fetus. Depending on the severity of each clinical case, the doctor makes the decision to have a hysterectomy or to have a hysterectomy. In case of emergency due to uterine rupture, large laceration, life-threatening blood loss, cesarean section hysterectomy will be performed. In cases where the disease is detected early, the new pregnancy mass invades the bladder and has not caused uterine rupture, and the uterus is preserved by surgery.
Specifically, in case the fetus is small, has not put much pressure on the bladder and has not caused uterine rupture, the method of abortion and the insertion of the balloon into the uterine cavity at the old cesarean section may be indicated. On the other hand, when the size of the fetus is large, causing uterine perforation, the cesarean section, uterine-preserving stitches, combined with vaginal cervical artery ligation, and placement of a drainage device from the uterine cavity, are performed. Restoration of myometrium may be indicated.

After the procedure, the patient needs to stay in the hospital for monitoring and recovery. Depending on your health condition and surgical method, you can stay for a few days or a long time.

After surgery, health has not fully recovered along with a weak uterus. Therefore, a woman should not become pregnant again too soon, preferably at least 1 year before surgery. If pregnant again, it is necessary to have regular prenatal check-ups and health checks, especially to determine the position of the fetus, to ensure safety in the next pregnancy.
Prenatal screening helps pregnant women detect pregnancy at the old incision for timely intervention. Faculty of Fetal Medicine - Vinmec International General Hospital is the first unit in the North to deploy a one-stop prenatal clinic (OSCAR) providing a comprehensive screening package for pregnant women at 12 weeks. The clinic gives quick results on the same day of examination and screening.
Faculty of Fetal Medicine has successfully implemented advanced prenatal screening methods, helping to screen for complications for pregnant women, detect and timely intervene some abnormalities in the fetus from very early weeks of pregnancy. Soon. The examination and examination are always performed by a team of doctors with many years of experience. Therefore, it will bring the best results for the patient.