In my country, the average cesarean section rate reaches 46.5%, while the cesarean section rate in Guangzhou’s tertiary hospitals reaches about 60%. Cesarean section naturally leaves scars on the mother\’s belly and uterus. Obstetrics experts said that if the first pregnancy was a cesarean section and the embryo was implanted into this scar during the second pregnancy, the embryo would penetrate the uterine wall in the early stages of pregnancy, causing a high probability of uterine rupture, which may lead to the tragedy of bleeding.
One-child cesarean section, beware of uterine scar pregnancy
Recently, a 37-year-old woman who was only 3 months pregnant suffered from recurrent vaginal bleeding for unknown reasons. Fan Jianhui, deputy chief physician of the Obstetrics Department of the Third Affiliated Hospital of Sun Yat-sen University, said that after examination, it was found that the pregnant woman had performed a cesarean section for her first child.
After color ultrasound, abdominal MR and other examinations, the obstetrician quickly diagnosed her with \”scar uterine pregnancy.\” It turned out that during this pregnant woman\’s pregnancy, the embryo just \”settled\” at the incision scar of the previous caesarean section (the weakest tissue). The villi were implanted in the depression of the scar and continued to develop toward the uterus. uterine wall, causing uterine perforation, rupture, and bleeding.
Because pregnant women are at risk of heavy bleeding, and considering that her gestational age is still small, the risk of uterine rupture will be higher as her gestational age increases, so the doctor advised her to give up the pregnancy.
Fan Jianhui said: This situation is often encountered in obstetrics. Currently, due to the high rate of cesarean section, there is a relative increase in pregnant women with uterine scar pregnancies.
Vaginal bleeding in early pregnancy is the first symptom
Uterine rupture is a very serious obstetric complication. Once it occurs, it often threatens the lives of pregnant women and fetuses. It usually requires a concurrent hysterectomy. It is difficult to treat clinically and often occurs in the third trimester of pregnancy.
According to statistics from the Obstetrics and Gynecology Department of Panyu Hospital of the Armed Police, a patient with uterine scar pregnancy appears almost every month, and most of them are patients with irregular uterine bleeding. Wang Caixia, director of the Obstetrics and Gynecology Department of Panyu Hospital of the Armed Police, said that a small amount of vaginal bleeding in early pregnancy is often the first symptom of scarred uterine pregnancy. This symptom is similar to threatened abortion, ectopic pregnancy, etc. Therefore, if the doctor is inexperienced, he may not be able to make an immediate differential diagnosis in the early stage.
At present, most doctors believe that once a scarred uterine pregnancy is diagnosed, the pregnancy should be terminated immediately. The purpose is to kill the embryo, eliminate the gestational sac, preserve reproductive function and stop bleeding. Fan Jianhui said that this is because, on the one hand, it is difficult for embryos to survive. On the other hand, this embryo is also very likely to break through the uterus, causing massive bleeding and endangering the life of the pregnant woman.
Even if the villi are planted in the scar, they do not grow outward, but develop into the uterine cavity. Sometimes they can continue until a viable baby is born, but the placenta attachment continues to bleed, and the chance of placenta implantation is greatly increased, which is very likely It can easily lead to heavy bleeding in pregnant women.