Dear Adriana,
I do empathize your situation.
Pregnancy after 4 Caesarean sections does carry a very high risks of rupture of the
uterus during delivery and even sometimes during pregnancy,
retained placenta after delivery if it is implanted over the scar, post delivery bleeding, etc..
If you are under 9 weeks of pregnancy and are sure that you do not want to continue with this pregnancy, you may opt for termination of pregnancy by medicines which carries very low risk even after caesarean section.
WHO has recommended two regimes for such terminations:
1. Tab. Mifepristone to be followed after 24-48 hours by Tab.
Misoprostol 2. Tab. Misoprostol only regime: Tab. Misoprostol every 3-12 hours for up to 3 doses
These are very effective and safe methods for terminating pregnancy up to 9 weeks of gestation. It is advisable to ensure the completeness of
abortion by
ultrasonography.
These medicines are prescription medicines and need to be procured by Gynaecologists prescription only. They should be taken as per the instructions of Gynaecologist.
These medicines cause developmental abnormalities in the baby; hence the pregnancy should not be continued if the medicines fail to abort; then the pregnancy should be terminated by surgical methods like MVA aspiration. Since you are having 4 previous Caesarean sections, it will carry some extra risk; however under expert supervision, this can be carried out fairly safely.
If you decide to continue with this pregnancy (which I would not advise), you will have to be under continuous supervision of Obstetrician. The integrity of the scan may be assessed by repeated frequent ultrasonography. Any discomfort over the lower abdomen should be reported to the Obstetrician immediately. You may have to be in the hospital during last month of your pregnancy. This will have to be a planned caesarean delivery. This delivery has to be a hospital delivery.
Please maintain your health. Keep your
haemoglobin within normal range by regular consumption of iron and high protein diet. Please visit the Obstetrician for antenatal care more frequently and follow the advise religiously.
I hope you got the messages.
Dr. Nishikant Shrotri