Uterine Healing Post C-Section

Did you know that a little over 1/3 of all deliveries in the U.S. are cesarean? What you don’t know is, although it's thought to be uncommon, after having a c-section you have an increased risk of your uterus not healing correctly. The poor healing after c-section may leave a woman with a low grade contained infection, or a gap in the wall, or just a thinning of the wall of the uterus itself.

How well your uterus heals after a c-section can help determine the health of your next pregnancy, as it will affect where a new pregnancy can implant within the uterus. There is no specific of numbers of c-sections a woman can have and the risks rise slightly after more than just one previous c-section. However, if you have healed well, you are more likely to be healthier and have a lower risk in any future pregnancies should you want them. There is no set "number of total c-sections that is safe." Women often will have a third or 4th safely, but what is important is how the uterus heals each time. One way is to perform ultrasound assessment of your uterine scar. But: what can an ultrasound of your uterus really tell you about how well you healed after a c-section?

The site where the incision was at the time of a previous c-section is not a healthy place for a pregnancy to grow. In fact, it may lead to potentially dangerous growth of placenta into the wall of the uterus where it will be very difficult to remove at the time of delivery. Yet it is not uncommon to find an early pregnancy discovered within the uterus implanted in the previous c-section site, and as a gyno we do see these types of pregnancy on ultrasound. And the more carefully a gyno looks at the placenta at the time of ultrasound in early pregnancy, the more cases we are finding.

A study was done and reported in the March 2011 issue of Obstetrics and Gynecology that was designed to understand the healing of one's uterus, the chances for abnormal placenta location, and the likelihood that uterine scar is separated or ruptured after the C-section. Women in this study had their uterus evaluated after their most recent c-sections; 6-9 month post partum by transvaginal ultrasounds. Out of 162 women with prior c-sections, 20% had an intact scar, 58% showed a small defect while 22% revealed a large defect.

We suggest any patient with prior cesarean delivery with irregular bleeding, pain or pregnancy planning now think about this as a possible diagnosis or cause and we are suggest they come in for a consultation, and as part of the consultation, to consider having an ultrasound and Saline Infused Sonohysterography to evaluate the c-section scar more completely.

Passing Your Uterine Lining, Menstrual Period Norms

Decidual Cast Periods can be fairly easy, passing some tissue at a time, or off can come the whole lining in one piece called a decidual cast. Generally the lining of the uterus is only 6-8 mm thick at the time of the menstrual period, and it is shed gradually, a few cells at a time. The decidual cast is when the entire lining passes spontaneously. It's not uncommon, but it usually both uncomfortable, and alarming to some. But us women are designed to have some sort of periods Or Not? We have to pass tissue each month. Or Not? Are they good for us? Or Not? Do we want them? Or Not? Is this something that is individual? Or Not? It's a complex topic that I will be discussing a lot over my time in this blog. So lets start with basics: How much do we bleed and what are we loosing, and just what was this that the patient passed? And another basic: track your periods, and the Women's Health Practice site http://www.womenshealthpractice.com/media/pdf/menstrual_chart.pdf you...

You Have an IUD: But a Positive Pregnancy Test

Fortunately IUD pregnancy failures are rare. But if you have an IUD for contraception, and you get a positive pregnancy test, you probably ask yourself, what next? Well, make your gyno appointment promptly, this is a condition that is not typically an emergency, but it can be and it’s not handled over the phone or on a blog, or through self diagnosis! That being said, some researchers from University of Texas Southwestern Medical Center in Dallas decided to look back at over 4100 women who had IUDs and of those 42 cases who became pregnant in their institution, over about a year period of time, to help understand what these women could expect when they got to their gyno and what actually happened to their pregnancies. Accurate pregnancy diagnosis, pelvic examination, and pelvic ultrasound were the cornerstones of the evaluations. They had very specific ways they looked at their ultrasound to prove there was no pregnancy in the fallopian tube, or partially in the fallopian tube...

Post-Endometrial Ablation Syndrome

If you have had an endometrial ablation and have developed symptoms of pelvic pain you might have post endometrial ablation syndrome. What is post-endometrial ablation syndrome? It is a constellation of symptoms due to entrapped blood or tissue within a uterus that has previously undergone an endometrial ablation. We are able to diagnose this at Women's Health Practic e but occasionally other conditions are causing similar symptoms. Other complications of endometrial ablation include pregnancy, risks from pre-existing conditions such as a polyp or fibroid, an infection of the uterus, or a pregnancy. If you have had a tubal ligation then it is possible that the condition could be post-ablation tubal sterilization syndrome. The ablation procedure is designed to destroy all lining tissue, but in fact there is no way to confirm the completeness of the ablation. It is thought that either residual or regrowth of the tissue is producing the symptoms of post-endometrial ablation syndrom...

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