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Re: Pregnancy after Endometrial Resection

From: William McIntosh, MD (anonymous@obgyn.net)
Tue, 21 May 2002 13:49:24 -0500 (CDT)

At Tue, 21 May 2002, Melissa wrote: >
>I had a transcervical endometrial resection in October '99. This past
>weekend 5/17/02 I had a late miscarraige of an approximately thirteen
>week old fetus the miscarraige occured after 19 weeks lmp. While I was
>certain, at the time of my resection, that I did not want more children,
>my attitude has since changed. My husband and I would like very much to
>try again. Are there any suggestions that anyone has for me, does
>anyone know of successful pregnancies post resection. I phoned my
>consultant in England today. He said he was unable to complete the
>resection with rollerballing and that he had wanted to look into
>microwave tecniques in the future. I am not sure if this means that it
>was only a partial resection, or a full resection with parts of the
>uterus intact. My husband and I are desperate to try to conceive again
>but if the precedent is that the baby is carried and then the placenta
>becomes weakened or is not viable past a certain stage then this would
>affect my decision as the trauma of this miscarraige has been
>substantial. I suppose my question is, if I was able to carry the baby
>through for as long as I did should I assume that the problem was due to
>the weakened uterine lining and that my uterus as it is cannot support a
>placenta.
>
>I do hope you can answer this question and I thank you in advance.

While I don't really have any insight into your specific pregnancy odds, the data indicates that what few pregnancies do occur after endometrial resection are quite high risk. Miscarriage is extremely common, and for those that carry to term, dysfunctional labor is common, with a higher than average risk of C/S. There is also a considerable risk of a placenta accreta/percreta, a condition where the placenta grows into or through the uterine wall. This is extremely hazardous for the mother, and frequently results in a hysterectomy at the time of delivery, large volume blood loss, multiple transfusions, and occasional maternal death. 

--
William D. McIntosh, MD, FACOG


This is for educational purposes only, and is not a substitute
for consultation and examination by a licensed medical professional.



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