Third cesarean section after 2 cesarean: how long, features of the operation, risks, doctors' opinion

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Pregnancy is undoubtedly a wonderful time in the life of every woman, but it does not always go smoothly. As medical statistics show, every year more and more girls cannot give birth on their own, so they need surgical care. Especially difficult is the third caesarean after 2 caesarean.

It creates a great risk to the he alth of the expectant mother and her baby, and also increases the likelihood of developing various serious complications, including even internal uterine bleeding and death. However, this does not stop women, and they refuse to have an abortion, preferring to give birth again. Let's see how dangerous this is and what consequences such a decision can lead to.

Possible complications of surgery

This aspect should be read first. After cesarean, not only scars remain on the woman's reproductive organ, but also occursmany structural changes that can be asymptomatic for a long time. At the site of the seams, scars are formed, which are seals of the connective tissue. Unlike muscles, they are not elastic and do not stretch. As a result, during the third pregnancy, the uterus does not increase in size as the fetus grows, which negatively affects its development. But this is not all that is dangerous for the third caesarean section. It can lead to the following:

• violation of the functioning of the internal organs of the small pelvis;
• anemia;
• incomplete patency of the fallopian tube;
• damage to the intestinal wall;
• endometriosis;
• improper fixation of the embryonic organ;
• delay or stop the development of the embryo;
• fetoplacental insufficiency;
• oxygen starvation baby;
• bleeding;
• intestinal hypotension;
• acute blockage of blood vessels;
• slow uterine contractions;
• sepsis;
• development of purulent infections;
• scar failure.

If a woman is scheduled to have a third caesarean section, a third pregnancy is also dangerous because there is a great threat of uterine rupture, which can lead to the death of the patient. With such a problem, the chances of saving the baby are almost zero, so doctors are trying by all possible means to save the life of the mother. But even despite the high level of development of modern medicine, this is not always possible.

Contraindications for surgicalintervention

This aspect should be given special attention. A third cesarean section after 2 cesareans is a very risky step, so doctors go for it only for lack of another way out. Before the procedure, patients should undergo a complete examination for the presence of any severe pathologies. These include:

• cancerous tumors;
• autoimmune and chronic diseases;
• pathologies of infectious etiology occurring in an acute form.

In the presence of any of the above problems, the operation to surgically extract the child is strictly prohibited. In addition, doctors take into account the state of he alth of the woman. The thing is that the uterus after a caesarean section becomes less elastic, so it may not be able to stretch to the desired size. As a result, the fetus stops developing and various serious pathologies appear. Therefore, throughout the pregnancy, the expectant mother will have to constantly visit the doctor.

Due dates

Doctors determine the time of surgery individually for each patient. This takes into account not only the clinical picture of the patient, but also the features of the previous operation. When is the third caesarean section safest? If the first procedure was carried out at 38–39 weeks of gestation, then the next one is prescribed 10–14 days earlier. As a rule, doctors prefer not to delay too much, since any delay increases the risk of serious complications. The question of reducing the period may arise if there are the following problems:

• complete occlusion of the internal os by the placenta;
• breech presentation;
• suspected seam divergence;
• uterine bleeding;
• deterioration of the woman's condition;
• multiple pregnancy;
• diagnosing HIV or dangerous infectious diseases;
• emergence of a threat to the he alth and life of a woman in labor.

In the vast majority of cases, if a third cesarean is performed, the third child is born premature and weak, but he remains viable. Therefore, after the operation, he is placed in a special incubator, in which he will remain until he reaches the desired body weight.

Examination before surgery

Let's take a closer look at this. For a caesarean section to go smoothly, a woman must visit the hospital regularly for ultrasound examinations. With its help, the attending physician can assess the condition of the uterine scar and the growth of the reproductive organ. In the second trimester, carrying a fetus, an examination is recommended at least twice a month. As the birth approaches, ultrasound must be done every 10 days. But it all depends on many factors. When monitoring expectant mothers, doctors take into account the following nuances:

• clinical picture of the patient;
• age;
• place of fixation of the uterus;
• features of pregnancy;
• availability of relateddiseases.

If a girl has any he alth problems, the risks increase. Therefore, doctors are much more likely to prescribe appointments for pregnant women in order to prescribe timely treatment if necessary and increase the chances of a successful birth.

Features of the operation

So what do you need to know about this? If the expectant mother needs a third caesarean, reviews of qualified specialists will be given at the end of the article, then she is placed on a stationary basis a few weeks before the expected date. In this case, the following events are assigned:

• comprehensive examination;
• colon cleansing.

In the event of any he alth problems or threats to life, emergency hospitalization is carried out, and the timing of the operation is shifted. The uterus after caesarean section is already damaged and has scars, so as not to injure it even more, surgeons make an incision in the same place as last time. Particular attention is paid to blood clotting, since the genital organ contracts worse, then there is a threat of internal bleeding.

Anesthesia is selected taking into account the patient's he alth status and the presence of concomitant diseases. Spinal epidural anesthesia is considered the safest, so it is most often prescribed. After the operation, the woman should stay in intensive care until her well-being and state of he alth return to normal. This usually takes a few days, but every case is different.

When can I have a baby afterprevious COP

It must be remembered that any operation does not go without certain he alth consequences. This is especially true for cesarean section. Therefore, if you are planning to have another child, then you need to take this very seriously. Doctors recommend women not to take such desperate steps, assuring that it is better to do sterilization altogether. However, the fair sex does not cease to be interested in the question of when it is possible to become pregnant after a second cesarean.

It takes at least two and a half years for the body to fully recover from surgery. Therefore, it is not recommended to have a child earlier, as well as after 6 years from the moment of cesarean. These terms are set by doctors for a reason. It takes about 27-28 months for a scar to form. If pregnancy occurs earlier, then there is a risk of divergence of the seams. A uterine rupture can result not only in the death of the fetus, but also in the death of the mother.

If you've had 2 c-sections, a third birth can be very difficult. There is also a high chance of developing various serious complications. To reduce your risks, you should take the following precautions throughout your pregnancy:

1. Have sex, be sure to use reliable contraception.
2. Periodically check in the hospital to make sure the stitches are intact.
3. Check future pregnancy with your doctor and get treatment if necessary.

If you take the matter seriously andif you follow all the recommendations of qualified specialists, then the chances of successfully bearing and giving birth to a baby are quite high.

What to look out for

If you are having a third caesarean section after 2 caesarean sections, then you should visit the doctor regularly and have an ultrasound scan. Before planning a pregnancy, it is very important to make sure that the sutures are tightened and a scar has formed in their place. You will also need to be under the constant supervision of a doctor throughout the entire period of bearing the baby. The following symptoms are cause for concern:

• feeling of heaviness in the lower abdomen;
• spasms and pains;
• dizziness;
• unpredictable spikes in blood pressure;
• Vaginal discharge mixed with blood.

All these symptoms may indicate a rupture of the seam, which poses a great threat to the he alth and life of a woman. Therefore, when they appear, you should immediately contact the clinic.

Preparation for surgery

Let's take a closer look at this. According to doctors, the third caesarean after two should begin with planning. It is very important to calculate all possible risks before surgery and take measures to minimize them. Strictly prohibited:

• abortion;
• scraping;
• womb surgery.

After the completion of the rehabilitation period, it is necessary to be examined by a gynecologist. He will refer you for ultrasound, hysteroscopy andcontrast hysterography. Based on the results of the tests, the doctor will draw up a clinical picture of the patient's state of he alth and decide what to do next.

How long does it take to recover from surgery?

As has been noted many times before, a third caesarean section after a 2nd caesarean is a very serious operation with many risks. Therefore, it is difficult to say how long the rehabilitation will take. It all depends on the age of the woman, how successful the intervention was last time, what diseases she has and much more.

Doctors let patients go home after a few days, provided they feel well and there is no intrauterine bleeding or infection. But in order for a dense scar to form at the site of the seam, it takes several years. However, there are no specific tips or methods that would speed up the recovery process. It all depends solely on the characteristics of the body and the state of human he alth. The only thing that depends only on you is compliance with all doctor's prescriptions and regular examinations.

Doctors' opinion about the third caesarean section

Reviews of the third caesarean section among physicians are mixed. However, all doctors are more attentive to women who have undergone surgery several times during childbirth. This is due, first of all, to the high risks and danger posed by the operation.

The uterus belongs to the group of internalorgans that do not tolerate any mechanical impact. When carrying a fetus, its size increases by 500 times. The scars formed at the site of the seams reduce the elasticity of soft tissues, which is fraught with certain consequences. No doctor, no matter how experienced and qualified he may be, can guarantee that during the entire period of pregnancy the reproductive organ will not burst. The gap in most cases ends in death, and it is not possible to save a person. Therefore, it is not surprising that doctors are reluctant to take on problem patients, because they do not want to take on additional responsibility.

To reduce the risk of ruptures and possible complications before childbirth, women should avoid additional physical activity: do not lift weights, give up sports training. Even intimacy may be undesirable if the doctor determines any abnormalities in the structure of the scar.

Conclusion

Expectant mothers should take their he alth very seriously and protect themselves as much as possible from everything negative. This is especially true for women in labor who are about to have a second or third caesarean section. To reduce the likelihood of complications, it is necessary to exclude or at least reduce physical activity, try not to freeze and constantly undergo a routine examination by a gynecologist. In this case, even after repeated cesarean, the chances of a normal birth are quite high. Take care of yourself and your unborn child.