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Can Multiple C-sections Increase The Risk Of Uterine Rupture?

Posted on Wed, 22 Mar 2017

Question: Hi,
I have had 3 previous C-sections and was told after my last delivery, 5 years ago, that there is scar tissue and that the bladder is getting attached to the uterus with scar tissue.
I have to have another elective C-section, which will be my 4th!
Can I ask please:
1) How much does having 3 previous C-sections increase my risk of uterine rupture? Doers this only happen if I go into labour?
2) How much does having3 previous C-sections increase my risk of having placenta abruptia?
Many thanks

Answered by Dr. Ramadevi Wani (58 minutes later)

Brief Answer:
Details below.

Detailed Answer:
Hi,
Welcome to HealthcareMagic,
I am Dr Ramadevi WaniI. I will be answering your concern today.

Uterine rupture usually occurs when you go into labor. Silent rupture is rare. The symptoms of silent rupture are persistent pain in the scar area which may or may not increase in severity. On examination there will be tenderness in the scar area in such a case.

The risk of having placenta previa is about 3% and placenta accreta is about 67% in your case.
Having previous Caesarean section does not significantly increase your risk of having abruption.

I hope this is helpful. Feel free to ask further.
Best wishes,
Dr Rama

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Ramadevi Wani (12 hours later)

Thank you for your reply.
On my 20 week scan they found my placenta was upper anterior. Does this mean that my risk of placenta abruptia or placenta accretia is lower?
I understand c-sections are always done in the lower part of the uterus so am I safer now that my placenta is upper?
If so, what do you think my risk is now?

Thanks very much.

Answered by Dr. Ramadevi Wani (1 hour later)

Brief Answer:
Details below.

Detailed Answer:
Hi,
Welcome back.

If the 20 week scan has shown upper placenta then definitely you do not have placenta previa. So naturally you will not face its related complications like placenta accreta.

Your risk for placental abruption does not increase because of the previous cesareans. Your risk of having placental abruption will be as that of general obstetric population i.e, about one in 150-200.

If you have further concerns I will be happy to answer.
Best wishes,
Dr Rama

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ramadevi Wani (25 hours later)

Thanks very much for the informative reply.

I am now having yellow discharge. It does not have an offensive smell, although it is not odourless.
I am scared to have more upper vaginal swabs as I've already had a few this pregnancy.
Do you think it is normal to have yellow discharge at 21 weeks (it is not light but not dark, sort of inbetween). There is not much of it.
I'm considering trying optiBak probiotic supplement for women to try return my discharge to white.
Please let me know what you think.
Many thanks

Answered by Dr. Ramadevi Wani (7 hours later)

Brief Answer:
Deails below

Detailed Answer:
Hi,

Having yellow discharge daily is not normal. You may use Optibak probiotic and see whether symptoms improve. If the symptoms do not improve, you need to have vaginal swab culture again.

Best wishes,
Dr Rama

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ramadevi Wani (13 hours later)

The yellow discharge disappears completely when I take the optiBak but comes back as soon as i stop taking it.
What could this mean?

Thanks

Answered by Dr. Ramadevi Wani (27 minutes later)

Brief Answer:
Continue Optibak

Detailed Answer:
Hi,
You can continue to take Optibak once daily for two months. By then the vaginal flora may normalize.

Best wishes,
Dr Rama

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ramadevi Wani (2 days later)

Dear Dr XXXXXXX

Are upper vaginal swabs safe in pregnancy?
I've had at least 4(!) so far this pregnancy due to ongoing itching and now I think I have to have another one as I'm still getting yellow discharge and itching.

Is there any risk with upper vaginal swabs such as infection?

Thanks

Answered by Dr. Ramadevi Wani (32 minutes later)

Brief Answer:
Yes upper vaginal swab test is safe.

Detailed Answer:
Hi,
Welcome back.
There is absolutely no risk with having high vaginal swab during pregnancy. Go ahead and have the swab test. It is needed in your case.

Best wishes,
Dr Rama

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ramadevi Wani (30 hours later)

Dear Dr XXXXXXX

I tried stopping the canesten cream and the daktacort cream until I get the results of the swab. I've been on these creams for approximately three weeks.
Unfortunately after one day, the itching got very severe so I had to apply the creams again. When I apply them the itching gets better.

Can you suggest what might be going on here? Does it appear I have thrush as the itching stops with the creams?
On the other hand, how can I stay on these creams for so long?

I am quite worried.
Thanks

Answered by Dr. Ramadevi Wani (17 hours later)

Brief Answer:
Details below.

Detailed Answer:
Hi,

Since you are responding to antifungal treatment, you seem to have fungal infection.
This recurrent candidiasis is sometimes difficult to treat.

The swab result will denote the appropriate treatment to be used.

I hope you have been checked for diabetes. Are you on any antibiotics? These are predisposing factors for recurrent candidiasis.

Wear cotton undergarments. Avoid bubble bath. Avoid oral sex.

Best wishes,
Dr Rama

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Raju A.T