Most women believe that a cesarean section is a cosmetic procedure that “facilitates” rapid labor. It must be clearly stated that this is a very complicated surgical procedure and the degree of its complication depends on the individual situation of the patient, which can sometimes cause serious problems.
- In the obstetrician community it is said that “cut is unequal”, which means that no two cuts are the same, each birth is different
- A caesarean section has a number of consequences in a woman’s body. They are comparable to the consequences of the most difficult surgical operations
- The greatest challenge is the healing of the postoperative scar, which affects the functioning of the female body and possible further pregnancies.
- That is why it is so important that the indications for the “cesarean” are only medical, and not based on the patient’s wishes
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«Cutting not equal to cut»
A cesarean section involves surgical opening of the abdominal cavity, making an incision in the appropriate place in the uterus and extracting the fetus. Then what has been cut needs to be sewn. In the description it looks simple, but it is quite a large surgical procedure and very apt in the obstetrician community is the saying “uneven incision”, saying that no two cesarean sections are the same.
This procedure causes a number of consequences in the woman’s body, which is comparable to the consequences after the most difficult surgical operations. Women should be aware of that Caesarean sectioning can have a number of medical complications.
Of course, in situations which are an indication for a cesarean section, the procedure should and is indisputably performed. However, it should be remembered that it is unacceptable to perform a cesarean section on request. There are strictly defined medical indications for this treatment.
- See also: Urgent caesarean section – the risk is greater than the benefits
It is very important that these medical indications are real and not forced by patients in various situations. Although the technique of cesarean section is mastered and in most cases the procedure is successful, but there are situations ending with unpredictable complications, such as hemorrhage, infection, damage to the bladder, intestine or ureter.
It is especially important to carefully qualify and perform the first cesarean section. This first cut has a number of possible medical and health consequences for the future. It has a particularly large impact on the course of subsequent pregnancies. In most cases, it leads to subsequent cesarean sections – that is, another “entry” to the abdominal cavity, which becomes more and more dangerous with each subsequent operation.
The healing of any wound, including surgical ones, is associated with the fusion of cut adjacent tissues. However, they do not always fuse anatomically. It often happens that an adjacent organ grows to the incision site, such as the bladder or intestines, which drastically impedes subsequent entries into the abdominal cavity, for example during another caesarean section or other gynecological surgery.
Scar and its consequences
For us, doctors, when assessing the condition of the reproductive organ after cesarean section, the most important thing is to assess the quality of the scar within the uterine muscle.
Once the uterine muscle is incised, even after it has fused properly, it will never be the same as it was before the cesarean section. The scar is not as stretchy and flexible as an uncut muscle. The consequence is a lower tensile strength of the uterus at the scar site. This is especially important in the next pregnancy. Such a situation creates a risk of uterine rupture during pregnancy or during natural childbirth.
There is also a risk of the embryo implanting in the scar, which poses a threat to the mother’s life. Such a pregnancy is an extreme danger for a woman due to massive hemorrhage and we consider it an ectopic pregnancy.
- What is an ectopic pregnancy? How to recognize it?
Another complication associated with a cesarean section is the possibility of the placenta ingrowth into the scar during the next pregnancy, which may lead to perforation of the anterior uterine wall and thus endanger the life of the woman and the fetus. It is one of the most difficult and dangerous clinical situations in obstetrics, the so-called placenta previa – overgrowing the uterine muscle.
The rest of the text is below the video.
When to heal a scar?
The optimal healing of the uterine muscle after cesarean section is when a scar has formed over the entire thickness of the muscle. However, many women develop a cesarean scar defectie the scar will not cover its entire thickness, but a differently large part of it. It is important that patients return for a postpartum gynecological check-up in order to see in the nonpregnant uterus whether the cesarean scar has healed properly or if there is a defect, and if so, to what extent.
Depending on this, we determine whether it is dangerous to the patient or not. Further management depends on the woman’s procreation plans and clinical symptoms that often make normal functioning difficult. These symptoms include: continuous, irregular spotting, pain, recurrent inflammation of the genital organ or general discomfort in this area.
Patients who do not want to give birth anymore, as long as the scar is not a clinical problem, can live peacefully with the defect. However, if it is a nuisance of a high degree, such conditions should be treated – in the first stage, pharmacologically. On the other hand, patients with a defect who plan to conceive another pregnancy must be thoroughly diagnosed in terms of the possibility of complications in the next pregnancy.
Depending on the degree of the defect, we suggest appropriate medical treatment. From hysteroscopic procedures through transvaginal, laparoscopic or even subsequent opening of the abdominal cavity. It should be mentioned that these are not simple procedures and require appropriate experience and skills as well as specialized equipment. In tests that diagnose the strength of a scar before the next pregnancy, we determine whether a given defect requires surgery. If not – then we must still be aware of the fact that each subsequent pregnancy must be treated as a high-risk pregnancy and carefully monitored for the risk of uterine rupture.
The topic “C-section Scar” contains two threads. One is the most medical one, with possible consequences in the next pregnancy, i.e. the scar of the uterine muscle, and the other, which our patients pay more attention to, is the scar of the skin.
It is obvious that for most women what matters most is the appearance of the skin scar. We understand this and try to make it as cosmetic as possible. However, we often have no influence on it. A scar thickening, the so-called scar, may form on the skin. keloids, not very nice looking. The method of skin healing depends on many factors, including individual predispositions. In some people, an incision in the skin heals perfectly, and in others, by cutting the same, sewing the same, the tissue heals unsightly.
There are various preparations applied to the skin available on the market, whose task is to improve the appearance of the skin scar, as well as methods of aesthetic medicine that serve this purpose, e.g. laser therapy, which mostly gives quite good results.
The article comes from the “Conscious motherhood” campaign prepared by Warsaw Press, whose media partner is the medTvoiLokony portal. All materials can be found on http://www.warsawpress.com/.
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