Causes of pregnancy sticking to the old cesarean scar

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor I Pham Thi Yen - Obstetrician - Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital.
Pregnancy stuck in the old cesarean section scar is a dangerous pregnancy complication, which can lead to uterine rupture and massive bleeding, even death for the mother. The increased rate of cesarean section is the leading cause of the increased rate of ectopic pregnancy at the cesarean section.

1. What is pregnancy attached to uterine incision?

Normally, after being fertilized, the egg will attach to the fundus of the uterus, where there is a thick enough muscle layer for the fetus to implant and grow. C-section scar pregnancy is a type of ectopic pregnancy caused by the pregnancy implanted in the surgical scar on the uterine muscle. This is the rarest form of ectopic pregnancy.
Pregnancy clinging to the old uterine incision was first discovered in our country in 1997. At this time, the pregnant woman had massive bleeding due to natural miscarriage. From that time, doctors became interested in this phenomenon and classified it as a dangerous obstetric complication, despite the fact that only about 1% of pregnant women experience the above complication.
There are two types of fetuses that stick to the old uterine incision:
The pregnancy is implanted in the old caesarean scar and develops mainly in the uterine cavity. The fetus implanted deep into the muscle layer and fibrous part of the uterus at the site of the old cesarean scar.

2. Is the pregnancy attached to the old uterine incision dangerous?

When the gestational sac attaches to the uterine muscle, because this muscle layer is thin, the placental spines can penetrate the bladder causing damage to the bladder, making the uterus vulnerable to rupture. In addition, when the fetus attaches to the scar tissue, this tissue layer cannot stretch like normal tissue, so it is easy to tear the incision, causing miscarriage. If the fetus clings to the old uterine incision, if not diagnosed and treated early, it can lead to many serious complications such as uterine rupture, massive bleeding requiring hysterectomy and life-threatening. Complications of pregnancy attached to the old uterine incision also depend on the position of the fetus:
For the type of pregnancy with partial attachment in the cesarean section, the fetus that develops mainly in the uterine cavity may still progress to the third trimester. In the second and third trimesters, the placenta is pulled up when the lower uterine segment is formed, low or progressed to the placenta. For the fully implanted fetus in the muscle layer and the cesarean section if the fetus develops into the second and third trimesters there are many risks including uterine rupture, massive bleeding, placental invasion of the bladder, High risk of hysterectomy, increased risk of death.

3. Causes of pregnancy sticking to the old uterine incision

The rate of cesarean section tends to increase, which is the leading factor causing the increase in pregnancy at the old uterine incision. The cause of ectopic pregnancy in cesarean section scarring is unknown. But the most accepted hypothesis is that the blastocyst closes into an opening in the scar on the myometrium from a cesarean section, surgery on the myometrium, or injury to the myometrium after manual placental abruption, due to dilation. curettage or endometriosis in the myometrium.
The gestational sac attached to the uterine scar cannot be held because the larger the pregnancy, the higher the risk of uterine rupture. Therefore, for women who have had a cesarean section, when having a second pregnancy, it is necessary to have an early examination to determine the exact position of the fetus. Early detection of pregnancy clinging to the old incision helps to preserve fertility.

In order to give the mother a healthy pregnancy as well as minimize the complications that may be encountered during pregnancy. Vinmec International General Hospital has developed a package maternity service as a solution to help pregnant women feel secure because of the companionship of the medical team during pregnancy. When choosing Maternity Package, pregnant women can:
The pregnancy process is monitored by a team of qualified doctors Regular check-up, early detection of abnormalities Maternity package helps to facilitate the process. Birth process Newborns receive comprehensive care Dr. Pham Thi Yen has 11 years of experience in examination and treatment in the field of Obstetrics and Gynecology. Doctor with strengths and deep understanding in:
Examination and consultation of normal pregnancies, pathological pregnancies, high-risk pregnancies Examination and treatment of gynecological diseases: cervicitis, cervical ectropion Surgery Laparoscopic surgery for gynecological diseases: ectopic pregnancy, uterine tumor, ovarian tumor Surgery for breast, vulvar, vaginal, cervical tumors Obstetric surgery: cesarean section, examination and treatment of women's endocrine disorders at all ages: puberty, reproductive age; perimenopausal age.
>> See more: Prevention and treatment of chills in cesarean section - Posted by Specialist Doctor II Nguyen Thi Hoai Nam - Head of Pain Relief Unit - Department of Surgical Anesthesia - Vinmec International General Hospital Central Park

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