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Re: Dr. review please:adhesions, bicornuate uterus, lost pregnancy

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Mon, 29 Nov 1999 21:12:06 -0600 (CST)


At Mon, 29 Nov 1999, Jennifer wrote: >
>Could someone please give me any feedback on this situation?
>
>Background:
>(11 years ago) Preg. #1 delivered 40 weeks full breech by c-section.
>Bicornuate uterus discovered at that time.
>
>Subsequent peritonitis developed which resulted in a (long and horrible)
>6 week hospital stay fighting infection and collapsed lung, then full
>abdominal surgery to drain multiple abcesses.
>
>(9 years ago) Preg #2 early bleeding and then premature labor at 22
>weeks. Pregnancy lost. No cause given.
>
>(7 years ago) Abdominal adhesions caused looped bowel and severe
>blockage. Additional abdominal surgery required to release bowel.
>Surgeon recorded large amount of abdominal adhesion throughout.
>
>(Current) 17 weeks pregnant. (Finally got my courage up!)
>All fine - no bleeding. Pregnancy is on the larger (right) side of
>uterus.
>
>Questions:
>1.) I've been experiencing sharp, stretching pains over the last week.
>I've just started getting larger and I wonder if the adhesions have
>bound my uterus somehow?

Yes.

>Is there any way to tell?

No.

>
>2. I'm scheduled for an amnio next week (age 35 - no bad genetic
>history). Is it going to be difficult to get through the scar tissue?

Usually not.

>(I have a lot!) Does my history make the risk of amnio any greater?

Impossible to say for you specifically but usually not.

>Does
>the risk of premature labor increase?

Bicornuate uterus, by definition, will have a higher risk.

>3. What are any other risks associated with abdominal adhesions
>throughout pregnancy?

Outside of pain and "stretching sensation", nothong really (except for very uncommon possibilities).

>Bicornuate uterus?

Nothing else.

>
>4. Given this history, would you recommend VBAC?

Tough call. One would rather not operate again, but if an emergerncy were to occur, no one would want to go through the adhesions rapidly.

>
>Thanks in advance.

--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York

**Note: Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.

**Private emails cannot be entertained due to time constraints, consequently no private emails will receive a response.

**Thank you for your understanding ;-)




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