I wanted to have three children, but the doctor said: It's better not to have another child!

After the three children are opened, I wonder how many sisters want to add another companion to the child?

33-year-old Xiaowen wants to give birth to three children, but has already had two cesarean sections before, and is very worried about whether it is dangerous for him to get pregnant again.

During the physical examination, the doctor told her: two cesarean sections, you can get pregnant again, but Xiaowen is best not to, because there is a uterine diverticulum, and the risk of pregnancy again is very high.

This problem is not uncommon among mothers who have had cesarean sections and uterine surgery, and sisters who want to have a second or third child must pay attention to it.

Today, we invited Dr. Fang from the Second Affiliated Hospital of Zhejiang University to tell you about what is going on.

Uterine diverticulia, the incidence is quite high

The uterine diverticula is the appearance of a depression in the wall of the uterus, like a niche in our wall. The most common is the uterine diverticulum formed after cesarean section, also called "cesarean section incision diverticulum".

Because the incision does not heal well, a depression or space leading to the uterine cavity is formed.

Data show that mothers who have a history of different number of cesarean sections have a 19.4%~88.0% incision diverticulum, and the more cesarean sections they have undertaken, the greater the likelihood of diverticulum.

How did this diverticulum come about?

As madsering as it sounds: all the factors that can cause a poor incision to heal, such as:

1. The location of the uterine incision is biased

2. Suboptimal suture technique

3. There are infectious factors such as premature rupture of membranes and intrauterine infection during surgery

4. The mother has symptoms such as anemia and hypoproteinemia during pregnancy

These may cause incision diverticula.

✦ Why are caesarean sections prone to incision diverticula?

Many pregnant mothers will communicate with each other whether the belly is better than the horizontal mouth or the vertical mouth, in fact, no matter what the mouth on the belly is, generally speaking, the mouth on the uterus is a horizontal mouth.

Just as a balloon quickly becomes smaller when it is out of air, the uterus contracts rapidly after the baby is born. It's just that the contraction rate of the uterus is uneven, and if the incision position is not good, the upper part of the incision shrinks relatively quickly, and the lower side near the cervix contracts slowly.

Thick muscles where contraction is fast, thin muscles where contraction is slow, which may cause problems such as "unevenness" when the incision heals, uterine diverticula and so on.

What symptoms indicate the presence of diverticula?

If you had a cesarean section and your postpartum period is procrastinating, you are most likely to have this diverticulum.

Every time I come to my aunt, the first week may be similar to the previous menstruation, and the back is like the rain of yellow plum days, dripping, 10 days, 15 days or even 20 days.

If this is the case, it is necessary to go to the hospital for examination.

Because in addition to the problem of diverticulum itself, due to the long time of vaginal bleeding, there may also be secondary vaginal inflammation, pelvic inflammation, etc.

The simplest test is ultrasound, and if necessary, further confirmation such as contrast and MRI may be done.

Generally speaking, if you don't want to have a second or third child, as long as the symptoms do not affect daily life, you can leave it alone.

Can't have a second child if you have a diverticulum?

Depending on the situation, the presence of uterine diverticula increases the risk in the next pregnancy.

First of all, the embryo may implant into this "little hole" - this is equivalent to burying a thunder in the stomach, I don't know when the uterus will burst, and the bleeding is loud.

In addition, the myometrium at the diverticulum is originally thin, and it may be thinner in the second and third trimesters, even only 1~2mm, once contractions occur after term, it is also risky.

@杭州网

Sounds so scary, so there is this little hole, say goodbye to giving birth again?

Don't be nervous, divide people, divide situations. Clinically, doctors decide whether treatment is needed primarily based on the size of the diverticulum and the thickness of the myometrium at the diverticulum. There are two common treatments:

● Drug treatment: mainly includes short-acting oral contraceptives and traditional Chinese medicine, but it is only aimed at relieving vaginal bleeding symptoms, and has little significance for improving diverticulum itself.

● Surgical treatment: including hysteroscopy, hysteroscopy, transvaginal surgery, open surgery.

Hysteroscopic surgery is equivalent to repainting the "wall" at the diverticulum to improve symptoms; However, it does not thicken the "wall" at the diverticulum, so there is still a risk in regenerating one.

The latter three surgical methods are to remove and re-suture the diverticulum, which is equivalent to knocking out the old "wall" at the diverticulum and building a wall again. This makes it safer to get pregnant again, but it usually takes about 2 years to get pregnant again after surgery.

Therefore, we recommend that mothers who have had cesarean section must complete the ultrasound examination before becoming pregnant again to determine whether there is a diverticulum. If so, to determine the thickness of the myometrium at the diverticulum, ask the doctor to determine whether diverticulum needs to be treated first.

After pregnancy, the B-ultrasound about 50 days of early pregnancy is essential to determine whether the baby is in the uterine cavity or has grown into the diverticulum.

In addition, the thickness of the scar should be paid attention to in the second and third trimesters, and if it is very thin, only another cesarean section can be performed.

C-section, how many times can I do it?

I believe everyone has heard that caesarean section cannot be more than 3 times.

There is no way to give an exact number of answers to how many times the caesarean section capacity is done medically. However, the more cesarean deliveries, the higher the risk of pregnancy complications, and in addition to the uterine diverticulum mentioned earlier, the risk of pregnancy complications such as placental abnormalities and heavy bleeding will also be multiplied.

The best way to prevent these problems is not to have a needless cesarean section. Don't find various reasons to request a cesarean section just because of fear of pain, vaginal laxity, etc., when the doctor recommends a vaginal birth.

In addition, good weight control during pregnancy, appropriate physical exercise, regular prenatal examinations, timely treatment of anemia or hypoproteinemia are also very important.