What is your most visceral fear

4. Caesarean section and fear of rupture in pregnancy

Question:

Hello...
I am very concerned about the probability of a uterine rupture in the SS. So much so that I can no longer enjoy my SS. I already have 3 KS: 97 because of BEL, 99 NotKS, 07 planned KS because of previous KS. Now I'm surprisingly pregnant again in the 31st week. After the last KS, the operating doctor said that everything looked very good. No adhesions, no scarring - nothing would stand in the way of a new SS.

Now I've read a lot - including about a ruptured uterus in the SS. The child of a woman from the forum had to be fetched in the 35th week of pregnancy because the seam threatened to tear.

I am also not closely monitored, i.e. I only go for an examination every 4 weeks. The US did not look for the KS scar either.

Now it burdens me so much that I can no longer enjoy my SS. I pay attention to every niggle and I have the feeling that it pinches and tugs inside me.

How big is the risk that such a crack will happen to me? So far the SS has proceeded without incident. Everything is normal. Of course, I always have to lift the little one, etc.

Should the scar be checked in the US? Should I insist on closer examination? At the moment I am very afraid and afraid.

LG Anett

by amidala35 on 02/23/2009, 7:30 p.m.

 

Answer to:

4. Caesarean section and fear of rupture in pregnancy

Hello,

In the case of pregnancy / childbirth after one or more caesarean sections, particular risks arise mainly from the possible rupture of the uterus. This can occur during pregnancy (very rarely) as well as during childbirth.
One speaks of a complete rupture when the peritoneum over the uterus (visceral peritoneum) ruptures with partial prolapse of fetal parts into the abdominal cavity. This brings with it an acute risk to mother and child. If the seam diverges a little (seam dehiscence), it can run without symptoms.
The rupture of the uterus during pregnancy with regular labor is obviously so rare that there are no figures on this in the literature, even if the number of caesarean sections has increased significantly.
According to WHO information, the risk of uterine rupture for women after a caesarean section is around 0.32% (Spong CY et al. Risk of uterine rupture and adverse perinatal outcome at term after cesarean delivery. Obstet Gynecol 2007; 110: 801-7) . The risk of a rupture after a caesarean section is greatest with spontaneous delivery (0.74%) compared to a primary or secondary re-caesarean section.

In a study (Stamilio DM et al. Short interpregnancy interval: risk of uterine rupture and complications of vaginal birth after cesarean delivery. Obstet Gynecol 2007; 110: 1075-82) on the influence of the time interval between the caesarean section and the subsequent pregnancy on the risk of rupture it could be shown that all time intervals over 6 months including the above-average pregnancy interval over 60 months do not entail a statistically significant increased risk of a uterine rupture during childbirth

The WHO report shows that there is only one report for women without prior operations on the uterus (including caesarean section) and that it indicates an extremely low risk of (0.006%).

(Source: http://www.who.int/reproductive-health/global_monitoring/articles/uterinerupture.pdf)

There is no data available for the thickness of the uterine wall, since no conclusions can be drawn from this alone.

VB

by Dr. med. Vincenzo Bluni on February 24th, 2009

Answer to:

4. Caesarean section and fear of rupture in pregnancy

Mh ... I can now tell from this that a rupture is rare in the SS? Are more closely meshed controls not necessary? I'm not really cleared up yet.

Greetings Anett

by amidala35 on 02/24/2009

Answer to:

4. Caesarean section and fear of rupture in pregnancy

Hello!

My sister also had 4 KS and everything went very well.
Lately she was also very nervous and the doctor advised her to go to the hospital immediately if she went into labor.

But with her every KS was checked to see what the tissue looks like, because it was known that she wanted several children.

If I were you, I would tell the doctor about your fears and ask him to look at you more often. Then you are also calmer-

by greeneye on 02/24/2009

Answer to:

4. Caesarean section and fear of rupture in pregnancy

Hello,

yes, you can conclude that from this and more frequent checks are not necessarily necessary.

For this reason, please discuss the next steps with your treating gynecologist.

VB

by Dr. med. Vincenzo Bluni on February 24th, 2009

Answer to:

4. Caesarean section and fear of rupture in pregnancy

thank you very much for your trouble to answer my questions.

Greetings Anett

by amidala35 on 02/24/2009

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