Third cesarean section. Third pregnancy after two cesareans 3 cesareans a year later

Well, now, when a month and a half has passed after my cesarean section, I am ready to tell you how it was. It's not a joke for the third time. 2 scars on the uterus. After the second cesarean, the doctor no longer advised to give birth, but it just so happened.

How I got pregnant, I myself still do not understand, and my daughter is already a month and a half.))) We have always had protected sexual intercourse. So how it happened, I have no idea.

On April 30, I saw an implantation retraction. As a doctor, everything immediately became clear to me, except for one thing: WHERE ?!

On May 5th I went for an ultrasound scan. Pregnancy is not seen. I say look better, it is. Found a flattening in the uterus, where the embryo was only going to attach.

Everyone already knows me. I learned about all my pregnancies a week before menstruation for a period of 1-1.5 weeks.

How do they say you do it? In general, I myself do not know how)))

Honestly, there were torments about pregnancy. All the same, I was no longer recommended to give birth. Both first pregnancies were threatened, on dyufaston. Then I decided that everything was God's will and dyufaston did not drink. There were no threats during the entire pregnancy.

A trip to Sochi in a car with two children was planned in the summer. They did not give up the rest, only the car was changed to a train.

But the due date was approaching, and at 32 weeks I went to my invaluable and irreplaceable doctor, who was the first to take all three of my children in her arms.

She, of course, said that I was a risky lady, but there was nowhere to go either for me or for her)))

She brought my pregnancy to 39 weeks and on January 5, she hospitalized me in the hospital. A planned caesarean section was scheduled for January 7th.

For two days I rested in the hospital, I was terribly afraid. It seems to me that only those who do not know what it is are not afraid. I knew ... I knew inside and out. I knew that the worst thing was to survive the operation - it only gets better and better every day.

Well, here it is day X.

In the morning I was awakened by an invigorating enema. This is worth a separate conversation, because I have never been given an enema in this way!

I came across a very responsible nurse, apparently Soviet-style.))) She poured water into me, and I was also very responsible and really endured to the last, and when I was completely exhausted, I gave a voice, but she didn’t say everything and continued. I thought, girls, I was going to burst on fig. And then she said that everything !!! Anticipating, my own toilet bowl happily jumped off the couch ... yeah NOW !!! She took me by the hand around the ward for 10 minutes so that the enema would work better. But then EVERYTHING came out of me)) and I was solemnly lowered into the operating room.

First, the nurse of the anesthesiologist changed my clothes, put in all the catheters, connected the equipment.

She made me laugh as much as she could, because I was pounding with fear, but I held on at this stage. She really grumbled under her breath: "This is who invented to bleed on Christmas, this is what a sin." I was becoming generally creepy. And there is no time and nowhere to run - she tied me))

The next to appear in the operating room was the anesthesiologist, who slightly dispelled the situation. Ever since college, I remember that anesthesiologists are the most fun. Apparently the constant being "on the edge" in the profession, the sense of humor strengthens - without it nowhere. He jokingly performed manipulations. Measured the pressure, read the map. I wanted spinal anesthesia. We discussed everything and proceeded to the procedure. He turned me on my side and prepared the injection site of anesthesia.

And then my doctor entered the operating room, I was just turned towards the door. And apparently, something in me went out. All the same, she has already given birth to two children. And I started to cry. From fear, from self-pity, from the words of a stupid nurse. The doctor looks at me and says: "Katrin, should I leave?")))

Doctors began to insist on general anesthesia. They explained to me that in my sobs they would not be able to carry out the operation. And I myself understood that. And I understood the stupidity of the situation. A mother of two children, an adult aunt came to give birth to a third and roar like a girl.

I was given 2 minutes. Either I pull myself together, or general anesthesia. At the first two cesarean, they did a common one.

I understood that it was probably the last time I was giving birth, and I had never been present at my birth. And from a professional point of view, it was still interesting. Sick people are doctors))

I pulled myself together. The anesthesiologist ordered the surgeon to go to wash and began to administer anesthesia.

When the doctor came in, I already pulled myself together, we could communicate quite adequately. We discussed news, colleagues, weather. She got up to the table. I say: "you somehow check, don't cut me right away!))"

The anesthesiologist ordered to poke me with a scalpel. Well, apparently they poked, because the command “let's start” was heard.

And in a second I felt warmth under me. I realized that they were bleeding. The doctor told me what she was doing, that by the standards she should take the baby out in 4 minutes. I waited...

And then I felt that something was being pulled out of me with a pump and a disgruntled grunt))) still in my stomach, but already groaning. And at some point, as my stomach was blown away, it became easy, and the doctor was holding my daughter over me. I was attached, I could only watch. This moment and the look of my daughter are still very clear in my memory. After a few seconds, they put it on a tray, brought it to my face again and took it away for examination.

A minute later, the pediatrician said: "The child is healthy, weight 3750, height 56cm."

The surgeon once again clarified with me about the ligation of the tubes, I said that everything was in place, I did not change my mind. She started dressing. I felt so good that I decided to sleep. But my "kind" anesthesiologist began to ask why I closed my eyes, am I sick or am I sleeping? I said that I was sleeping and he said that it was not worth sleeping, let's better talk and ask questions, what I will call, etc. And then it became so painful that the dream disappeared like a hand. The doctor started drying. This is when the inside of the abdomen is soaked with blood. I thought that now I will definitely give birth. I tried to wriggle on the table, but I was motionless and only moaned. After drying, they began to sew and I felt every stitch of the seam. And I just asked the anesthesiologist whether it will end soon or not. But the surgeon said: “Katrin, that's it. Operation was successfully completed. The uterus was saved. The pipes were tied up. The uterus is overstretched. She can't stand pregnancy anymore. Now you will be transferred to the intensive care unit and I will come. " I felt really good. It's all over. My daughter is healthy on the first examination and so far nothing hurts me. There is a time to accept congratulations. The daughter, meanwhile, was taken out of the operating room to show her husband and then she went to the nursery.

They put me on a bed and took me to the ward. There were already girls there, everyone was happy. The anesthesiologist asked me how I felt and asked if he could leave for coffee. “Otherwise,” he says, “it's time to shit, but we didn't eat”)) I asked not to make me laugh, because the anesthesia began to recede))

I was waiting for a doctor. Because, firstly, she will bring the child for the first attachment, and secondly, I understood that another terrible procedure awaits me - a massage of the uterus. It cannot be avoided if unpleasant consequences are not needed. And so she came, my daughter took her breast right away, as here she was - you will not drink the experience. I also saw the sky in diamonds. Now you can rest, call everyone.

We lay there until the evening. In the evening, the nurse girls came and raised everyone. I had to go on foot to another building, to a paid ward. It took about 3 minutes to go there, well, I crawled, of course, longer.

And the country celebrated Christmas ...

That's how it was for me)))

This is not the end of the story. The next day, I started having complications from the anesthesia. Girls, I never thought that my head could hurt SO. All day trying to stop the pain - it's useless. And at night I was again taken to the operating room - they put a blood patch in the spinal space. Also scary. But it’s not like that anymore. By the way, the pain passed immediately. And our recovery period began, getting used to each other))

When they took blood from her heel, I cried again. The third time)))

All over again. I remembered the first birth, the second ...

At first I didn’t want to remember, but now it’s nostalgia. Thank God for everything! For the opportunity to give birth again, when she was no longer expecting. For such a welcome daughter. For a team of professionals next to me.

A third caesarean section is not uncommon today. The technique of the operation became more and more perfect every year. Once performed, a caesarean section does not restrict a woman's desire to have many children.

In the old days, caesarean section was a desperate operation. It was performed only on a dying woman in order to save a still living child.

Over time, to save the woman's life, they tried to remove the uterus after removing the baby. This saved the woman's life.

Unfortunately, they could no longer have children. Through the centuries, the uterus began to be sutured. Antibiotics have appeared.

Since that time, the number of births by surgery has increased dramatically. One cannot be surprised by the repeated operation.

Why is a third caesarean section common today?

Operation technique. Today, a caesarean section is performed with a transverse incision in the lower segment of the uterus. This incision heals well and quickly. Less bleeding during surgery. The scar is formed firmly, which reduces the risk of uterine rupture during subsequent pregnancy and childbirth. It was the use of this incision that allowed the woman to have more than one child after an operative birth.
Reducing drugs. The scarred uterus contracts worse and more slowly after delivery. This is fraught with bleeding and infection. The obstetricians came to the aid of medicines that help the uterus to contract in such difficult situations.
Antibiotics They were first used during the Second World War. In the post-war years, it was possible to make a caesarean section operation safer and to save women from childbirth fever. The fact is that after a cesarean section, infectious complications are not uncommon. Previously, because of this, the first cesarean was a fatal risk. Today, with a second operation and even with a third cesarean, there is an opportunity to save a woman's life, health and the opportunity to have more children.
Nutrition for women. For proper healing of a scar on the uterus, a woman needs a balanced diet. Sufficient consumption of meat, fruits, vegetables.
Lifestyle. A woman in modern society is rarely engaged in hard physical labor, eats well, lives in a warm house with all the amenities. This is an important moment for maintaining her reproductive health and the ability to survive 3 or even 4 caesarean sections.

Third pregnancy after cesarean. Features of the course of pregnancy

Important! A woman who is carrying a third child, if she gave birth to previous ones through an operation, is at risk. She deserves the close attention of doctors.

The fact is that there is a scar on the uterus. This is a weak point in which connective tissue predominates. During pregnancy, the uterus increases in volume by a factor of 500.

The muscle tissue of which it is composed is well adapted to this, but the connective tissue is not very well adapted. Therefore, the risk of rupture of the uterus along the scar increases even during pregnancy. In this case, it matters:

How much time has passed since previous operations. Ideally, 1.5-2 years should pass. But no more than 4-5 years. The fact is that during this period, muscle tissue predominates in the scar and it is the most wealthy. After 4-5 years, calcium salts are deposited in the rumen and it undergoes sclerosis - compaction, loses its ability to stretch. Up to 2.5 years, the scar is still at the stage of formation. It tears easily and becomes thinner during pregnancy.
Did the woman have abortions, operations and how much time has passed since them. Abortion disrupts the formation of a scar on the uterus.
How was the postoperative period. If there were complications, infections, then it will be difficult to endure pregnancy.

What to look for during pregnancy?

Scarring. To do this, ultrasound is regularly performed during pregnancy and not only the growth and development of the child is monitored, but also the condition of the scar on the uterus, their consistency and thickness.
If the placenta attaches to the wall of the uterus in the area of the scars, then it will not work well here. This can delay your child's growth. In addition, during pregnancy, the placenta may adhere firmly to the area of the scar on the uterus and not separate after childbirth. In this case, the uterus will have to be removed.
Any physical activity, weight lifting should be avoided.
Don't have a sex life.
If there are pains in the lower abdomen or spotting, weakness, dizziness worries - call an ambulance immediately !!!

Features during childbirth

With one scar on the uterus, you can have a discussion about what to do with a second pregnancy: childbirth or surgery. But after the second cesarean birth through the natural birth canal is extremely dangerous and fraught with rupture of the uterus.

The third and subsequent caesarean is technically difficult to perform. It has more complications. It's related:

with adhesions in the abdominal cavity, which remains after any operation. Adhesions can interfere with the extraction of the baby. Their preliminary dissection may be required. This will lengthen the operation time. Ruptured adhesions can cause bleeding and damage to nearby organs - the intestines, bladder, and fallopian tubes and ovaries.
with insufficient uterine contraction. Scars will make your uterus less likely to contract. And the operation may result in severe bleeding from the uterus, which will require its removal.

The risk of complications is higher if a woman has had abortions, inflammatory diseases of the uterus, a difficult postoperative period after previous operations, if little time has passed after previous operations.

Interesting! During surgery, doctors may suggest that you have your fallopian tubes ligated to sterilize and prevent future pregnancies. This is due to the fact that if you become pregnant for the fourth time, the difficulties with pregnancy and childbirth will be even greater. But 4 and even 5 operations are not new today.

Features of the postpartum period

In the postpartum period, you will also have to face difficulties and peculiarities.

At first, it will stretch over time. The uterus will contract worse. Because of the scar.
Secondly, the scar will also heal worse and slower.
Thirdly, the risk of bleeding and infection increases.
Fourth, subjectively, you will feel that your stomach hurts more. This is due to painful contractions of the uterus, adhesions that remained in the abdominal cavity, repeatedly injured tissues and nerves.
Fifth, it will be more difficult to restore the old tummy and remove the saggy skin. And it will take much more time.

Dear ladies, don't be intimidated. Medicine does not stand still and every year the skill in performing repeated operations is being honed.

Gone are the days when an operation once performed did not allow a woman to give birth again. But, the third pregnancy after two caesarean pregnancies has its own complications. You must be prepared for the difficulties. And the task of doctors is to help you overcome them.

Women, whose first pregnancy ended with a caesarean section, while planning a second child, will definitely think about when they can try to conceive a baby so that it is safe for life. In this article, we will talk about when and how to plan a pregnancy after a cesarean section, characterize the main features of carrying a baby with a scar on the uterus after a previous birth.

Today, 20% of pregnant women undergo a caesarean section for medical reasons. As a rule, the doctor after delivery (based on its results) will tell the new mother if she can become pregnant with her second child.

Why a woman after a cesarean section may be prohibited from giving birth:

She has chronic heart diseases, for example, arterial hypertension, defects, rheumatism. Such diseases can lead to intrauterine growth retardation of the fetus, the placenta may even exfoliate or labor will begin prematurely.
The woman has pathologies associated with the organs of the genitourinary system. It can be chronic pyelonephritis, urolithiasis, cystitis. All these ailments threaten premature birth, intrauterine infection of the fetus, preeclampsia.
If the new mother has problems with the respiratory system, for example, asthma, chronic bronchitis. Due to these diseases, during the second pregnancy, the fetus may experience oxygen starvation, it will not develop correctly, and become infected with an infection in utero.
You cannot give birth if a woman has diabetes mellitus, since because of it, the fetus can develop chronic malformations in the development of internal organs.
Childbirth is prohibited if the young mother has thyroid disease. Because of them, the second pregnancy may end in miscarriage, the child may be born mentally retarded.

In all other cases, pregnancy after a cesarean section will be allowed, but not earlier than 2-3 years, until the scar on the uterus is completely healed and the woman's body is fully restored. If you neglect these recommendations and allow the next pregnancy to occur a month after the cesarean, then it can end in death for both the woman and the baby. After all, an unhealed scar on the uterus can disperse during a new pregnancy, and this is a real disaster, which, as a result, leads to death.

The scar will fully heal only after 24-30 months, which means that you cannot plan a pregnancy even a year after cesarean. All this time, a woman is simply obliged to protect herself during intercourse with the help of contraceptives.

2 years after giving birth by caesarean section, a woman planning a pregnancy needs to visit an antenatal clinic to be examined. The doctor must make sure that the condition of the scar and connective tissue on the uterus is satisfactory. You must understand that competent, mandatory planning of pregnancy after a cesarean section can prevent risks and complications, which means that you can fully experience the happiness of motherhood once again. Any initiative in this matter is a fatal mistake.

If you did everything correctly, and after a couple of years you managed to conceive a baby, then your pregnancy will proceed in this way:

You will have to visit the gynecologist very often and follow all his prescriptions.
The same applies to ultrasound diagnostics, which you will be prescribed very often to track the condition of the scar and suture after a cesarean, which ended in a previous pregnancy.
It will not be possible to exercise and lift weights, since this will cause pain in the lower back and in the lower abdomen during the second pregnancy after cesarean.

As for childbirth, it should be noted that the rule "one cesarean - always cesarean" has long lost its force. If a woman had only one childbirth, carried out by an operative way, then the second time she can give birth on her own, but under certain conditions:

At least 2 years have passed since the first cesarean.
The pregnant woman has no serious illnesses.
The course of pregnancy passed without complications and pathologies.
The fetus is positioned correctly in the womb.

But even if, according to all the above parameters, a woman can give birth naturally, a cesarean will still be prescribed for her if she has a multiple pregnancy, and her age is more than 30 years.

Pregnancy after the second cesarean

The third pregnancy after cesarean is very risky. It will definitely not end with natural childbirth. Its outcome is another cesarean.

Gynecologists will urge a woman to take a third pregnancy after two surgical deliveries very responsibly. She will certainly need to go through two such procedures:

Hysteroscopy is a micro-operation performed to examine the condition of the uterus.
Hysterography - X-ray with contrast, which will give doctors an idea of the state of the reproductive system of a woman who is going to give birth for the third time after two cesarean sections.

If a woman has an early pregnancy after the second cesarean, and she did not have time to go through all the necessary examinations, then it is not a fact that the doctors will allow her to keep the baby. Most often, according to reviews, gynecologists recommend interrupting such a pregnancy after a cesarean.

Pregnancy after 3 cesarean, as a rule, does not occur. Firstly, because the woman's body is already worn out. This is especially true of the uterus, which has 3 scars left after previous operations. It's another matter if the 4th pregnancy occurred after one cesarean section, which ended the third pregnancy. She can, with a successful course of bearing a baby, end with a natural delivery.

Video: "Childbirth in patients with a scar on the uterus after cesarean"

In the video below, the doctor of the Russian clinic "Mother and Child" talks about all the features of the course of pregnancy after a cesarean section.

Most doctors, to whom women came to give birth at least twice in advance, offer to undergo a sterilization procedure, since a third pregnancy after two caesarean sections can not only have dire consequences, but also lead to death. However, this does not happen often and most women have the opportunity to give birth to a healthy child without severe complications for themselves for the third time.

Risks and complications of the third caesarean section

Having a cesarean section for the third time is a big risk for both the mother and the baby. It is the duty of every doctor to warn in advance about possible problems, since the health of both mother and child is at stake. Even despite the great experience of many obstetricians, they cannot fully assure a problem-free delivery in this situation, since it is difficult to predict the body's response to the third cesarean section.

The use of a cesarean section for the third time has the potential to lead to a large number of adverse consequences. They can be pelvic deformity, dysfunction, bowel or bladder damage. Complications can lead to the need for amputation of the uterus, to uncontrolled hemorrhage.

Indications for the third cesarean section

If for a woman the third pregnancy is fundamentally important to the extent of personal reasons, and after two previous births it is clear that natural childbirth is impossible, then doctors strongly recommend waiting for an absolutely complete recovery of the body after the last birth. Since the rehabilitation period takes a very long time, it should be carried out under the supervision of specialists. Doctors say that on average, this process takes at least three years. Some couples faced with this problem sometimes resort to sterilizing a man, and at the end of the rehabilitation period, artificial insemination is performed using the sperm of a previously sterilized partner.

The most important event for every couple is the birth of their first child. And important during childbirth is the choice between natural childbirth and by cesarean section. Despite the fact that the option of giving birth in a natural way is the most favorable, it is not always possible due to the individual problems of the woman's body. Then there is nothing left but to give birth by cesarean section. Postoperative rehabilitation is aimed at favorable healing of the suture scars on the abdomen and on the woman's uterus. However, the next pregnancy is already more risky, due to the presence of a suture on the uterus, the tissue of which is less elastic.

Features of planning pregnancy after cesarean section

If it was decided to get pregnant a second time, then for a successful birth, you need to consult a doctor. The terms of the caesarean section must be agreed. For this, a number of examinations are carried out, which include the use of the methods of hysterography and hysteroscopy.

There are a number of cases where a second pregnancy after a caesarean section cannot proceed safely. It mainly depends on the health status of the woman. In no case should you neglect the examination of the health of the body before subsequent childbirth, the health and life of the unborn child, as well as the mother, depends on it. The subsequent pregnancy completely cancels the presence of the following pathologies in a woman:

Having one or more medical conditions and having a caesarean section makes a successful second birth unlikely. The ban on childbirth is compulsory due to the high risk of death of both during childbirth. Doctors may recommend sterilization after a second caesarean section.

Caesarean section is of two types: transverse and longitudinal. Carrying out a longitudinal cesarean section completely excludes the possibility of natural childbirth during the next pregnancy. With a transverse caesarean section, vaginal delivery is more likely because the uterus is less prone to rupture.

After a cesarean section, there are a number of strict prescriptions for a successful subsequent pregnancy:

It should be borne in mind that during the next birth, if they are natural with the permission of a doctor, the use of painkillers is excluded. Using pain relievers will cause the uterus to spasm violently, causing it to rupture.

Childbirth after two caesarean sections

Successful pregnancies after two caesarean sections are not uncommon. In no case should you worry too much about your child's health if you follow all the doctor's instructions. If the conditions of pregnancy are not followed, doctors may refuse to perform a cesarean section. Due to the thinning of the walls of the uterus after previous operations, which is a great risk to the health of the baby. It is very rare to have a caesarean section more than 4 times.

Considering that the most favorable period for the healing of uterine scars is at least three years, as a result of premature pregnancy, constant monitoring of the uterine scars is carried out to prevent unforeseen consequences.

After a successful third cesarean section, it is of paramount importance to objectively assess the condition of the uterus using ultrasound in the last trimester of pregnancy. The successful delivery of childbirth for the benefit of the mother and the child directly depends on the fulfillment of the doctor's prescriptions during pregnancy, so you should always remain attentive to the doctor's words.

Caesarean section more than three times

There is definitely a great risk of having a caesarean section more than three times. Currently, doctors are increasingly faced with pregnancy after two caesarean sections. Also frightening is the desire of women to resort to using a caesarean section for the fourth or even the fifth time, despite the high probability of adverse consequences for the health of the mother and baby.

It will not be superfluous to contact the antenatal clinic before starting the next planning for the subsequent pregnancy, in order to obtain the most objective forecast of successful childbirth. There are frequent cases of misunderstanding on the part of doctors, which is due to the unwillingness to take responsibility for the life of the mother and child, in case of unforeseen situations during the operation. Only the results of an MRI scan can provide accurate data about a woman's health status for the subsequent planning of a successful pregnancy.

Immediately after positive results for the third pregnancy after two caesarean section operations, you should immediately contact the antenatal clinic to register and conduct all the necessary examinations. The main thing is to remember that self-confidence and a successful childbirth have a much greater impact on the birth process than the influence of doctors, since doctors, to the best of their professional duties, need to warn about any risk.

2016-09-12 12:45:09

Irina asks:

Hello, please tell me I have a planned cesarean section for a period of 39 weeks and I have a small temperature 37 there are no more manifestations of a cold, will they do a cesarean at this temperature?

Answers Bosyak Yulia Vasilievna:

Hello Irina! Low-grade fever may be normal during pregnancy and is due to the production of progesterone. Have you checked your kidney function? Is there no protein in the general analysis of urine? If not, you can plan a cesarean section.

2014-01-09 15:11:50

Ksenia asks:

Hello! In December 2013, I had a laparoscopy (Ectopic on the right, the tube was saved), Term 5 weeks .. nothing bothered, I saw a positive test, I went for an ultrasound scan myself .. the next day and operated on .. the doctor said that the fertilized egg it was in the fimbrial section of the tube .. he says they let in blue - the tubes are passable, and at the same time, the right tube was soldered to the ovary. In the past, cesarean section and abortion. Now I have undergone treatment - Amoxiclav (7 days), metronidazole, nystatin, longidase suppositories (10 pcs every day), aloe (7 days intramuscularly). One of these days I am going to undergo physical procedures (electrophoresis, ultrasound) The doctor also advises to undergo a course of hydrotubation 10 times ... Please tell me if I need to check the tubes before planning, what other treatment And most importantly, is it worth doing hydrotubation ????

Answers Palyga Igor Evgenievich:

In my opinion, hydrotubation is an outdated, ineffective procedure. Conservative treatment is sufficient. Even if one tube is impassable, the other will function and therefore pregnancy is possible. It is practically impossible to effectively restore the patency of the pipe, on which there was surgery. Visual patency was restored (blueing was gone), but it is very difficult to restore the work of the fimbriae (villi). Checking the patency of the tubes is required only if pregnancy has not occurred for 6 or more months of open sexual activity.

2012-11-19 09:30:01

Marina asks:

Good day! I'm 36 years old. There is a child of 11 years old, cesarean section. In September, there was a missed pregnancy, a period of 6 weeks. I really want to have children. As a result of cleaning, there is endometriosis of the postoperative scar (there were no diseases before pregnancy, examination by a gynecologist took place every 5-6 months, smears were always normal, histology was good). And since in the middle of the cycle, bloody discharge began for this cycle, 12 suppositories were prescribed and from the 16th day of the cycle, 10 suppositories were vaginally administered. The ultrasound was done on the 13th day of the cycle, the endometrium was three-layered, of the correct shape (as they said, beautiful), but only 5-6 mm. From the first day of the cycle, COC was prescribed. They offered several options - ZHANIN, YARINA, MEDIANA, REGULON. Can you please tell me which COCs are better to take in my case? I am also ready to listen to your suggestions.

Answers Gritsko Marta Igorevna:

The treatment was prescribed correctly, with regard to COCs I can advise you to donate blood for sex hormones - FSH, LH, prolactin, estradiol, which are given on day 3-5 m.ts. and progesterone, which is given on day 21 m.ts. This will make it possible to assess your hormonal background and choose the appropriate contraceptive. Considering your age, I think Regulon or Janine would be the best choice. Midiana and Yarina are similar drugs in which the dose of gestagen is higher. Than in Janine and Regulon.

2011-04-15 04:22:10

Tatyana asks:

Hello! Tell me please. On December 20, 2010, a small cesarean section was performed at a period of 21-20 weeks, Diamniotic Monochorionic twins, the girls died. Have diagnosed polyhydramnios. After what time can you get pregnant and if there is a chance that there will be twins again. what examinations need to be passed so that this does not happen again.

2008-12-22 12:35:25

Tatyana asks:

Hello, Doctor!
I have a pregnancy, the term is about 3 weeks, there is no way to save it, so we decided to have an abortion. I already have a baby, the birth was 2 years 8 months. back, emergency caesarean section due to clinically narrow pelvis. The postoperative period was uneventful, there was no inflammation, and there was no cleaning either. This is the second pregnancy, there were no abortions. There are no gynecological and venereal diseases. Age 24. The doctor offers medical abortion. At the time of taking the pills, the delay will be 9 days. Cycle 28-30 days. I have the following questions for you:
Is it possible to have a medical abortion after a cesarean? Will the uterine suture come apart? What are the possible consequences for my term.
Thank you in advance!

Answers Olga Filippova:

Hello. Medical abortion is indicated with a delay of no more than 10 days. It does not affect the state of the uterine suture, after a cesarean section, you can perform a medical abortion, some complications are possible (your gynecologist should tell you about them.

2008-04-19 17:24:39

Lyudmila asks:

Hello. In November 2005, I had a Cesarean section, the water receded and there were no contractions, I want another baby and I want to give birth on my own. What examinations and tests do my husband and I need?
My husband and I also have different rhesus (I have negative), the first pregnancy went like this:
From 3 to 16 weeks there was nausea and absolutely no appetite, as a result of which I did not gain weight during this period, for a period of 19.5 weeks I was put on support with the threat of a breakdown (there were pains in the lower abdomen). the rest of the pregnancy went great.
I recently found out that with different rhesus, injections are given, but my gynecologist did not tell me anything about these then, and now he says that he is not a supporter of this. Why? should i worry about my rhesus, do i need this injection?
Thank you in advance for your response

Answers Tarasyuk Tatiana Yurievna:

Hello! The examination before pregnancy consists of a general clinical examination (general blood tests, urine tests, reactions to syphilis, hepatitis, possibly HIV) to assess the state of the body. At the expense of different Rh-accessories. The basis in this issue will be the degree of manifestation of the Rh-conflict = the reaction of the mother's body to the Rh-positive child. To diagnose this condition during pregnancy, the level of anti-rhesus antibodies (killer proteins) is determined and, when they increase, treatment is carried out. The injections you are talking about are anti-Rhesus immunoglobulin - a blood preparation that "eats" the anti-Rhesus antibodies formed in your body and, thus, can reduce the reaction in subsequent pregnancies.
I should upset you - if the first pregnancy was resolved by caesarean section, then with the second one rarely will anyone dare to let the woman into labor. A scar on the uterus can cause serious complications (up to rupture of the uterus). Is it worth the risk?

2007-09-28 16:29:08

Nelya asks:

Hello! I am now 36 weeks pregnant. At the 15th week of pregnancy, for the first time, tiny (less than 1 mm) bubbles appeared on the abdomen - 5-6 pieces (when trying to squeeze them out, a clear liquid appeared). After this first appearance, bubbles began to appear in small numbers under the armpits, on the thighs. There were no painful sensations, only a little itching, and everything quickly passed in 2-4 days. At 33 weeks of gestation, bubbles appeared in the groin area, in the sacrum region and in large numbers on the chest (under the nipples), and on the chest they were accompanied by slight redness. The sensations are the same: it doesn't hurt, but it itches a little. At the same time, there were no complaints of headaches, or simply a bad general condition, or there was nothing else, except for the appearance of these bubbles. Now, at 36 weeks, they healed and disappeared (they healed on the chest for a long time, 3 weeks, in contrast to previous rashes). Now there is no itching or other uncomfortable sensations. A week ago, the gynecologist examined the vagina (just in case) and did not find any rashes (according to my feelings, they were not in the vagina at all). Since infections during pregnancy are dangerous, and I have a suspicion that it is genital herpes and I have been tested. The first analysis (for a period of 21 weeks) by PCR method: tested for herpes 1, 2 and for cytomegalovirus. All results were negative, i.e. I didn’t find anything. After the appearance of rashes on my chest (at 33 weeks), I donated blood from a vein. Result: IgM - negative, IgG - 1:64 titer (> 1:16 Past infection). Those. it turns out that I have found "old" antibodies to genital herpes. But before pregnancy, I have NEVER had such rashes and in general any complaints related to this. I suppose that the infection was ongoing or latent, or I became infected during pregnancy, but then either PCR or a blood test would show the presence of infection (IgM would be positive, for example). There are no complaints now (there are no new rashes, at least not yet); Ultrasound shows that the child is developing normally (structure, weight, heartbeat, placenta condition, etc.). I would like to know what to do now. The problem is that I am not in Russia (I am in Cyprus), and, unfortunately, there are no specialists here. My local gynecologist advises to do an analysis again at 38 weeks: blood for IgM, and if it is negative again, then there will be nothing to worry about. But I asked my Russian gynecologist for advice (by phone). He said that the analysis should be done only by the PCR method at 37-38 weeks (because a blood test in this case will not give anything). And in general, you can drink something that strengthens the immune system a couple of weeks before giving birth. Please tell me your opinion about my situation: 1. What kind of analysis for genital herpes to do: IgM? IgG? or is it PCR - what really helps to determine the presence of infection? 2. When is it better to do it - how many weeks before delivery? 3. What medications to take (which of the simply strengthening and which in case the analysis shows the presence of an active infection) - harmless for the child 4. And one more thing: here the doctors just a little, just do a cesarean section. And I read that in the case of genital herpes, it does not help and, especially if there is no outbreak of the disease during childbirth, and the birth canal is without infection, then you can give birth naturally, only at the same time treat the birth canal and the baby's skin with an antiseptic. Is it obligatory to process? Is it not bad for the child? And should a child be tested for genital herpes immediately after birth? By what method? How do you advise? I really hope to get an answer from a specialist. Thanks.

Answers Markov Igor Semenovich:

Hello! The clinical picture of the disease described in the message does not correspond to the clinic of HSV infection during pregnancy. However, more accurate and complete information could be obtained by examining the contents of the vesicle by PCR, which makes it possible to identify HSV DNA. To identify the replicative activity of the herpes simplex virus (which you have - this is confirmed by the presence of antibodies of the IgG class), you should do PCR of blood, vaginal discharge and scraping of the epithelium from the cervical canal and urethra. This analysis should be done as soon as possible, so that, if the answer is positive, there is time for preventive treatment, which will protect the fetus from infection. In this case, the analysis will need to be repeated weekly - until delivery (monitoring of HSV). The only safe for the fetus and effective medicine against HSV infection is human HSV immunoglobulin for intramuscular administration. If you start giving birth before preventive therapy, you will need to have a cesarean section (regardless of the location of the virus). If the tests done by the PCR method give a negative result, it will be possible to give birth naturally. The treatment of the genital tract with disinfectant solutions does not give a 100% guarantee of protecting the child from infection directly during childbirth. Also, I do not really advise treating the skin of a newborn (during birth through a vaginal birth canal). Only some areas of the skin and mucous membranes are subject to processing (umbilical wound, conjunctiva of the eye, skin and mucous membranes of the external genital organs of a girl, mucous membranes of the oral cavity). The child will also need to be examined shortly after birth - to donate cord blood for both types of HSV. The ELISA method is used to test for antibodies of the Ig M and Ig G classes, by PCR - for viral DNA. Before childbirth (or immediately after), you should also determine the level of IgG antibodies to HSV ½ in your blood and compare the result with the level of antibodies in the baby. If the child is not infected, this indicator will be lower than that of the mother. Be healthy!