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Thread: TTC after classical cut c-section

  1. #1

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    Default TTC after classical cut c-section

    I was wondering if anyone knows or has had exp with this.. I had a classical cut C-Section to deliver my twins at 24wks and 2 days gestation.. When they were still alive my OB spoke to me about subsequent PG, but because they were still alive & I had such a traumatic labour and delivery.. (9 days in labour as they kept it going for as long as they could.. The longer the bubs were in there the better) I said oh no I will never have anymore!! Anyway I was sure she told me had to wait 2yrs to allow for healing and to prevent my uterus ruptering, but after my bubs died and I went for my 6wk check up I asked again and he only told me I had to wait 12 months.. Now I would really like to try again as it took me 8yrs to concieve Taite and Seth (yes miraculously it was natural!!) But I would hate to fall PG before I am properly healed and therefore probably suffer another loss.. Any advice would be appreciated..


  2. #2

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    Blessedatlast, I am so sorry for your very heart breaking loss . My thoughts and prayers are with you and your family.

    I don't know if I can help, but I had an operation called myomectomy done on my uterus 3 weeks ago which is similar to a c/s. My doc told me to wait for 3 months for my uterus to heal enough to start a new pregnancy. Saying that though, I can't have a natural delivery next time as the chance of the uterus bursting is very high past 38 weeks. So the only thing I can do is have a c/s at 38 weeks.
    Maybe because you want a natural birth, they reccommend waiting 12 months which would be adequate time for your uterus to heal, without a risk of rapturing. I would suggest to see your OB and ask the question again, or get a second opinion from another OB.

    Take care hun, I wish you much peace and happiness for your future.

  3. #3

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    I can't answer your question but I just wanted to say how very sorry I am for the loss of your 2 beautiful angels. I hope you find comfort and support amongst us and you recover quickly. Best of luck on your journey and take care

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    Hi Blessedatlast,

    I am so sorry to hear about the loss of your twins . what a terrible thing to go through. I can completely understand that you don't want to wait a long time to ttc again. I can't give you any information regarding this issue, sorry but I must say the fact that your OB said 2-years (which sounds v long) then said 12-months, makes me think that it would be worth getting a second opinion from a high-risk OB.

    Good-luck with it all. Please feel free to join a group of us in the TTC after late loss thread, we would love to support and share with you.

  5. #5

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    removed
    Last edited by BabyButterfly; March 31st, 2009 at 01:42 PM.

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    Default Rupture

    Hi Blessedatlast,

    I am very sorry for your loss, I know how you feel. I actually saw your website and the boys names done by Carly 'names in the sand' before I knew you had the classical scar. It all gets scary when you get to the upper part of the uterus apparently, where all the blood flow to the uterus is.

    I delivered our beautiful baby girl in December in an emergency due to a uterine rupture. They believe it was caused from an earlier m/c/d&c which left a whole in my uterus. Although it was a pin hole it obvioulsy stretched and Sophie kicked through it at 32 weeks and ripped the top of my uterus open. Her oxygen was cut off and she was born sleeping, I almost died from the rupture. It's like a 1 in 100,000 risk for that to happen.

    So my OB is working with us to check my uterus and rebuild what we can in the hopes we can try again in another 18 mths... it's only been 3 1/2 mths. We were also advised to wait at least 18 months after losing Sophie to try. We will also be having special ultrasounds to check the stability and thickness of the stitched areas. But even then they cannot guarantee a healthy delivery, I would be bed ridden from 20 weeks and they would deliver around 28 weeks so there are other risks there too... that's if it didn't rupture earlier and we lose the next baby too.

    The trouble is the closer you get to the top of the uterus the more blood flow is there and that's why there is a risk. My OB would prefer me not to try again and while I see your case is not nearly as bad as mine it seems time is the key for healing. Had we have waitied a few more months would be have been able to save Sophie? We will never know.

    As much as you want to be an earth mum, and as hard as it is to wait I believe Dr's know the best... listen to them and you will delivery healthy bub or two.

    Good luck!

  7. #7

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    Default Rupture

    Double post..oops
    Last edited by labbiekisses; April 1st, 2009 at 01:06 PM. Reason: Double post

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    Quote Originally Posted by labbiekisses View Post
    Hi Blessedatlast,

    I am very sorry for your loss, I know how you feel. I actually saw your website and the boys names done by Carly 'names in the sand' before I knew you had the classical scar. It all gets scary when you get to the upper part of the uterus apparently, where all the blood flow to the uterus is.

    I delivered our beautiful baby girl in December in an emergency due to a uterine rupture. They believe it was caused from an earlier m/c/d&c which left a whole in my uterus. Although it was a pin hole it obvioulsy stretched and Sophie kicked through it at 32 weeks and ripped the top of my uterus open. Her oxygen was cut off and she was born sleeping, I almost died from the rupture. It's like a 1 in 100,000 risk for that to happen.

    So my OB is working with us to check my uterus and rebuild what we can in the hopes we can try again in another 18 mths... it's only been 3 1/2 mths. We were also advised to wait at least 18 months after losing Sophie to try. We will also be having special ultrasounds to check the stability and thickness of the stitched areas. But even then they cannot guarantee a healthy delivery, I would be bed ridden from 20 weeks and they would deliver around 28 weeks so there are other risks there too... that's if it didn't rupture earlier and we lose the next baby too.

    The trouble is the closer you get to the top of the uterus the more blood flow is there and that's why there is a risk. My OB would prefer me not to try again and while I see your case is not nearly as bad as mine it seems time is the key for healing. Had we have waitied a few more months would be have been able to save Sophie? We will never know.

    As much as you want to be an earth mum, and as hard as it is to wait I believe Dr's know the best... listen to them and you will delivery healthy bub or two.

    Good luck!
    Hi
    Similar story to you, uterine rupture at 41+6, story in the birth announcements thread, part way through Milana's announcement. Would like to chat to you, as we have both been through something that is so rare. Can't PM you as you are new, but please email me on (email removed)
    Last edited by BabyButterfly; April 2nd, 2009 at 03:12 PM.

  9. #9

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    Hi and thanks for the replies.. I am sorry to everyone who has lost their precious bubs.. Well I had an appointment in Bris Wednesday, with the OB that I was under and these were my questions and how they were answered..

    1st of all I wondered when i I could safely fall pregnant since I had a classical cut C- Section??

    I thought a yr or 2.. She told me pref a yr, but ok after 6 months She says the uterus should have healed.. (Good we are nearly there)..

    Next was Chances of this happening again (premature labour)??

    The docs seems to think "probably not" She thinks my probs were related to 'multiple pregnancy'... I am happy with that, considering the chances of me falling again spontaneously with twins is like 1 in 200!!

    She wanted to check my cervix but because of this stupid Depo provera shot I am STILL bleeding!! Anyway.. I have an app with her in 3 months and if my cervix is 'crap' (yes she said that!) They will look at putting in a stitch earlier.. Monitor from 12wks, possibly stitch at 14. BUT if cervix looks good then maybe no need for stitch at all.. Hmm I wasn't happy with that. I think I will need one. BUT at least I will be closely monitored.. Better than an emergency stitch at 19wks while pregnant with twins !!

    Also she put me on the pill to stop this awful bleeding which every other doc has been scared to do due to my heart cond.. So the plan is for the next 2 months: To be on the pill then after 2 months come off it. Then there will be no contraception used and we will 'See what happens'.

    I am so scared of another pregnancy but I am 100% happy with the care myself and my babies recieved at Royal womens so... What will be will be??

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    I think the information you just provided is very reasonable from your Dr. With delivering at 24weeks I would imagine the incision would not be as large as it would have being if done at term so that should mean less time to heal well. The thing with classical incisions is the cut runs along the muscle which takes longer to heal then when the cut it through the muscle like it is in the lower segment of the uterus. The lower segment also doesnt need to stretch as much as the upper section which is why they suggest the longer healing time. Also with the stitch I think you are right. Better to have it done just to make sure then risk needing it further along in your pregnancy. A singleton would also put alot less pressure then twins. I wish you the best of luck and hope soon you will hold your precious baby in your arms after a smooth pregnancy.

  11. #11

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    Hi there,

    so sorry for your awful ordeal. I just wanted to share my story with you... almost a year ago my baby died in utero at 22 weeks and they induced me, but after an exam they discovered I had grade 4 placenta praevia and he had to be surgically removed. Because the lower segment of the uterus (which is what they cut in a normal C-section) doesn't form until 28 weeks or so they weren't sure where my scar ended up. I got pregnant again within 3 months and started seeing the high risk clinic. The doctor there was excellent, considered a leader in the field and he said my risk of rupture was somewhere between that after a normal Caesar and a classical but they didn't know know which. So I had another Caesar 10 days ago which went well, but they did say my lower segment was very very thin and actually opened up when they moved the bladder out of the way. They repaired it and said that I should wait 9 months to try again, and that after 9 months everything should be healed as good as it would ever be. The next time they can try monitor the uterine wall thickness through ultrasound but it's an imprecise art, only an indication and then look for an earlier delivery. I know he also said that with a classical that they would take the baby at 36 weeks. Also they monitored my cervix too because apparently a delivery late in the second trimester can weaken it, although it wasn't a problem in my case, and in yours you didn't go through labour either.

    Anyway, this is obviously a different scenario to you but I just wanted to say that many women do go on to have perfectly healthy pregnancies after a classical incision and it sounds like your doctor is giving you good advice and support. I know in my pregnancy having a doctor experienced in complicated pregnancies made me feel much more confident, I hope you do as well.

    Good luck!

  12. #12

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    Hi there,

    My pregnancy was considered high risk anyway cos of my heart condition then the fact it was a twin pregnancy too.. It is so ironic that I was only referred to Bris high risk due to my heart condition and my heart was perfect, no dramas at all yet I had obstetric problems.. If I didn't have a heart condition I would have just gone to Gold Coast and who know what kind of care I would have recieved.. I am just so glad that I feel confident and have full faith in Royal Bris hospital and the docs that looked after both me and my boys.. So 2 more months and I will be officially TTC.. I am scared but excited.. I have 2 months to get my health in check again as I have been smoking and drinking like a trooper since the boys died..

    Rozzie Sorry for your loss and congrats on your new bubba Wow 11 months to the day! I did labour when I was preg with the twins so this is also why my doctor needs to check my cervix.. She said that labouring with a stitch can damage and weaken it and I laboured for 9 days.. and there is no chance for VBAC which doesn't worry me.. I just want a healthy baby i don't care how it gets here..

  13. #13

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    Quote Originally Posted by Rozzie27 View Post
    Hi there,

    so sorry for your awful ordeal. I just wanted to share my story with you... almost a year ago my baby died in utero at 22 weeks and they induced me, but after an exam they discovered I had grade 4 placenta praevia and he had to be surgically removed. Because the lower segment of the uterus (which is what they cut in a normal C-section) doesn't form until 28 weeks or so they weren't sure where my scar ended up. I got pregnant again within 3 months and started seeing the high risk clinic. The doctor there was excellent, considered a leader in the field and he said my risk of rupture was somewhere between that after a normal Caesar and a classical but they didn't know know which. So I had another Caesar 10 days ago which went well, but they did say my lower segment was very very thin and actually opened up when they moved the bladder out of the way. They repaired it and said that I should wait 9 months to try again, and that after 9 months everything should be healed as good as it would ever be. The next time they can try monitor the uterine wall thickness through ultrasound but it's an imprecise art, only an indication and then look for an earlier delivery. I know he also said that with a classical that they would take the baby at 36 weeks. Also they monitored my cervix too because apparently a delivery late in the second trimester can weaken it, although it wasn't a problem in my case, and in yours you didn't go through labour either.

    Anyway, this is obviously a different scenario to you but I just wanted to say that many women do go on to have perfectly healthy pregnancies after a classical incision and it sounds like your doctor is giving you good advice and support. I know in my pregnancy having a doctor experienced in complicated pregnancies made me feel much more confident, I hope you do as well.

    Good luck!

    Hi Rozzie,

    What state are you? Can you recommend the Dr you used? We are going to be seeing a second opionion and want the best after losing Sophie.

    thanks
    Kylie

  14. #14

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    hi Kylie,

    I'm in Canberra so prob not much help for you in Sydney. I think most major public maternity departments should have a high risk clinic though?

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