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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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When Can I Try For Another Baby After A Miscarriage And Hysterotomy?

I had a miscarriage at 16 weeks and a D&E at 18 weeks. During the cervical dilation, the laminaria sticks perforated my uterus. This was discovered at the beginning of the procedure the next day and resulted in a hysterotomy to remove the fetus and repair the damage to my uterus. The incision was made through the fundus. I have had 2 previous low transverse c sections and a bicornuate uterus with a successful pregnancy in each side. I really want to try for another baby at some point in the future. But am concerned about uterine rupture. How long should I wait to try for another and what are my risks?
Fri, 7 Feb 2014
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OBGYN,  's  Response
Hello
Thanks for writing to us with your health concern.
It is quite risky for you to try to conceive again.
The reasons being -
1. Fundal perforations have high chance of recurrence.
2. Bicornuate uterus itself increases chance of preterm labour.
3. Previous 2 C sections make you prone to scar weakness.
Given these 3 factors in combination, even if you do venture out for a pregnancy, you would need to have an Elective CS quite early.
This could be even at 34 - 36 weeks.
If you are happy with two healthy children, I can see no reason for you to risk your life again.
It is best that your husband should go for vasectomy, so that you are never endangered again.
Do not take on the unnecessary risk of uterine rupture.
You were lucky yours was managed well, it can result in death at times.
If you DO want to try, wait for atleast 3 years before planning another child.
And I strongly discourage that.
All the best
Take care.
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When Can I Try For Another Baby After A Miscarriage And Hysterotomy?

Hello Thanks for writing to us with your health concern. It is quite risky for you to try to conceive again. The reasons being - 1. Fundal perforations have high chance of recurrence. 2. Bicornuate uterus itself increases chance of preterm labour. 3. Previous 2 C sections make you prone to scar weakness. Given these 3 factors in combination, even if you do venture out for a pregnancy, you would need to have an Elective CS quite early. This could be even at 34 - 36 weeks. If you are happy with two healthy children, I can see no reason for you to risk your life again. It is best that your husband should go for vasectomy, so that you are never endangered again. Do not take on the unnecessary risk of uterine rupture. You were lucky yours was managed well, it can result in death at times. If you DO want to try, wait for atleast 3 years before planning another child. And I strongly discourage that. All the best Take care.