Pregnancy and delivery after uterine perforation

[Expecting Mama]

Hi, I had my uterus perforated during IUD insertion. I had about 5 mm perforation in the fundus and did not need stitches, but there is still a scar. I am pregnant now, and my due date is about 2 years after perforation happened. I have been researching and read that fundal perforation could pose a risk of uterine rupture during labor and contractions. I am not sure what size perforations they are talking about, but I am scared out of my mind!  have also read that there is possibility of rupture before delivery and that a woman with a scar like that should be in the hospital 2-3 weeks before due date. Is it true? Are there any tests to check for a scar and see if it is healed completely? I am so scared of the uterine rupture since it could have a serious consequences. What is the rate of catastrophic ruptures of all the ruptures? I had a vaginal delivery 2 and a half years ago with no complications. What should I do? Should I still scedule a c-section just to be on the safe side? Has anyone been in this situation and went on having a vaginal delivery without complications? Does anyone know what is the risk of going through labor in my situation and if it would outweigh the risks of scheduled c-section? Thank you.

[rnra]

Have you been to an appointment with an OB/GYN yet?  If not, I'd suggest that you call to schedule one and discuss all of your questions with a qualified health professional.

[Expecting Mama]

Yes, i have been to prenatal care with the same OB who perforated my uterus. She says there should be no problem with vaginal delivery, but I am still scared. I am afraid that she is not saying everything. The OB who did laparoscopic surgery to remove IUD also said there should be no problem since the whole was small (that was the doctor from the same practice). I did not go to another doctor for a second opinion, since I would like to research it on my own first, that's why I posted here. What do you think?
 

[mrs_mandolini]

I have a relative who had a uterine rupture, subsequent to a uterine surgery. Her baby did not survive.

The relative of mine who this happened to had a myriad of other health problems including chronic lung disease and steroid use, both of which have very negative effects on wound healing. She died in her mid 30s of these health problems, if that tells you anything about how seriously ill she was in general.

She had two more children successfully after the initial rupture and was on bed rest in the hospital for weeks, both times. I am guessing that the information you "read on the internet" about having to be hospitalized, etc has to do with someone who has had a previous uterine rupture during pregnancy or labor (like her), rather than someone with a small surgical scar (like what you have.)

Think of it this way: if any woman who'd had her uterus cut into was hospitalized for a few weeks at the end of every pregnancy because it was so horribly unsafe, no one would be able to VBAC. And as you know, a lot of women do!

[pbjmama]

Your scar is 1/5 of an inch, a Cesarean scar is 4-6 inches. Women vbac all the time. Get a second opinion if it would ease your fears.

[Expecting Mama]

Thank you for your reply! It is very reassuring and makes sense. Wow, I am so sorry about your relative! I know her problem was 10 times more serious than mine, and it makes me feel like a total wimp! But at the same time, I am very worrisome person and may also have an OCD, so it is extremely hard for me not to worry esp. during pregnancy. Even though I know I should relax and everything should be ok in my situation, there is still some thoughts on the back of my mind that things could go wrong (nothing is ever 100%). So I am trying not to read to much but cannot help it.
 

[Baby A]

How is your pregnancy coming along? I read your posts and have the exact same issue as you. I've had consults with prenatal specialists. How far along are you now?

[Expecting Mama]

I am 38 weeks now. Everything goes well so far. They do weekly BPP and NST to check on the baby. I am not sure if it is scar related, and they started doing it after I had decreased fetal movement one day. So far I have talked to 3 different OBs, and they all said it would be no issue with vaginal delivery, plus they :coldare gonna monitor me in labor just in case. I am still kind of worried though, since I know there a little chance of uterine rupture even on unscarred uterus. . But did not hear of any uterine rupture in cases like mine. The women were able to deliver vaginally with no problem. What about you? What did your doctors say? How big and how long ago was your perforation? Are you pregnant? How far along?

[Baby A]

I'm  17 weeks and the perforation is 6mm long and my uterus in that area is only 2mm thin. Its really scary. What kind of scar did you have?  You have made it almost to the end, and I'm sure in your case a vaginal delivery will be fine. My OB referred me to a prenatal specialist and they are saying I may be hospitalized at 24 weeks for observation.

Please let me know what kind of scar you have.

[Expecting Mama]

I have had 6 mm perforation as well. It is in my fundus. It happened 2 years ago. When they did surgery 1 week after perforation they said it was well healed. During this pregnancy they did not measure thickness of the uterus there. Weird. My ob did not even send me to another specialist. I just talked to a couple of more doctors from the same practice. How far ago did your perforation happen before you got pregnant? Maybe it has to do with the time between perforation and pregnancy? Was the whole in the fundus? Thank you and good luck!

[Jennbee]

My sister-in-law had a rupture at 37 weeks after previously having a uterine perforation. I'm not sure how many mm it was though. She had an emergency c-section. Baby survived and tested well for development around 6 months. She was told that she would be in hospital on bed rest if she ever got pregnant again.

[Kelmarie]

Heres my story
5/25/09 gave birth to my son with no complications
6 weeks later had Mirena IUD inserted by Kaiser (hurt like hell)
July 2010 we decided to TTC again; went to Kaiser to get it removed and they couldn't find it; it had perforated my uterus
Sept 2010 had surgey through belly button and had it removed from my abdomen
November 2010 got pregnant
10 weeks later began to bleed and they could not find heartbeat; had DNC to remove
Couldn't get pregnant for the next year
Had HSG in January 2012; tubes clear and Dr said best time to get pregnant since "tubes were open"
Got Pregnant in February; had chemical pregnancy
Got pregnant in April; had chemical pregnancy
Referred to Kaiser infertility clinic
August 7th had saline ultrasound where they said I had some minimal scarring on my uterus
Scheduled hysteroscopy for 9/26
Somehow I miscalculated my ovulation and had unprotected sex in August and today I got a positive pregnancy test
Had blood drawn and now just waiting for my HCG and progesterone numbers to come back. Praying that I don't go through another miscarriage but also am going to be stressed the whole time that I will have complications.

[3rdbump]

Hi I have had the same Problem I also had an Iud inserted an it perforated my womb. I was told I couldn't have a natural birth again which devistated me as I had 2 natural births before with no complications and it was the best experience of my life. This was 4 years ago that I had keyhole surgery to have it removed. I'm now 11 weeks pregnant with my 3rd and terrified of a c-sec my other children are now 5 and 6 and im a hands on mum very fussy about making sure they are looked after properly which normally means to ensure that I do it I couldn't bare if I wasn't able to look after my children myself as the oh works away and it means trying to find somebody to help out. Anyway what are the chances of me having a natural do u know? Thankyou