I don't know where to post this question. I've looked everywhere on this site and generally on the internet, and can't find anything much to help me.

I've had retained placenta twice before, with a missed m/c and my son 7 years ago. I pretty much expected it again and was not surprised to find there was a 2.5cm chunk still there with some other small scattered bits.

Had a D&C at about 8 weeks, and came out 2 hours later to be told that I had a ruptured uterus. They used a forceps type device to pull away the 2.5cm placenta, and it came away with the uterine wall. It had been attached to the top wall. They did a laparoscopy and stitched up the hole, which the stitches continued to tear as it was so thin.

Unfortunately my OB went on leave at the end of that day, so I haven't talked with him since that evening. However I have had appt's with another in his practice.

It seems to be very doom and gloom for me to have another baby. They've told me that I would have to have a c/s, and most likely a hysterecomy afterwards, particularly if any part of the placenta mounts on the top wall again. I didnt see the "big risk", only now they tell me that the potential for blood loss/transfusions is high for having a hyst immediately after a c/s.

There is a risk too that the uterus could rupture during the pregnancy. I have a history of recurrent miscarriages, and another D&C is also risky and may result in a hyst. I can't have an IUD which is my preferred contraception as the pill doesn't agree with me.

I've been told there is a 30-40% chance that the placenta will at least partially cover the wound. It is possible that the placenta will grow through the thin wall and grow on other organs.

We hadn't talked about having more kids, but DD who is now 11 weeks old has been so much easier that DS 7 years ago. I think it is because I know I can cope and I know what to do (most of the time!! ). I had been thinking that I could do it again in a few years. But now the choice seems to have been taken away. That's what has affected me the most.

I'm trying to make a decision - whether to keep my uterus and try for another baby in a few years. I will be interested in anyones experiences with pregnancy/birth after a rupture.

If the risks are too high of me or my baby dying as a result of this condition, then I am thinking of having a hyst anyway. My thoughts are if I can't have babies, then why keep my uterus and continue to have periods which is annoying. I can't see the point in having my tubes tied for contraception when I will never have it reversed to have kids anyway, and will still have periods.

I don't want to lose my uterus if I could have a healthy baby in the future, and it doesn't kill me!!

I hope someone can help me.

My advice would be to take it slowly.

You don't have to make any big decisions just yet, and who knows- when you are ready to decide on another baby in a few years time, there may be more research/advice on what to do after a uterine rupture.

I'm thinking what you had is placenta accreta where the placenta grows further in the uterus than it should and can't come away after birth? If so it is usually a big complication- but can be properly planned for and managed.

A surgeon wouldn't perform a hysterectomy on a woman of childbearing years without major consultations as obviously its completely irreversible. Why not consider some of the contraceptions that have little to no periods like depo.

Best of luck, I'm sure you'll find over time you settle on a decision that is right for you and your family.

Hi Lois,
Not sure if I'll be much help but I'll give it a go
My uterus ruptured during the birth of my third DD, (my first birth was twins and a c/s). My second bith was supposed to be a VBAC at home with a midwife but it wasn't to be and after 3 nights of labour we transferred to hospital for an epi and induction (with a small dose of synto. We thought we'd have to argue with them to try some synto but as it happened they were more than happy to use it and subsequently ended up using too much and my uterus ruptured complete with a couple of tears. Wasn't a pretty look apparently.
Anyway, I did speak to the registrar afterwards and he seemed quite happy with the prospect of another birth. Even went so far as to suggest that the next c/s would be performed at 39 weeks However this was the same registrar who assured me that the dose of synto they used on me had nothing to do with my uterus rupturing He must have thought I was a complete idiot and was probably more concerned with me suing. I haven't questioned a private OB for a second opinion yet but we are unlikely to have more children regardless.
Like you though I do feel that the option has been taken out of my hands.
Have you seen your OB again yet? I'd be interested in what he has to say. I definitely wouldn't be opting for a hysterectomy just yet, your baby is still so young, you just can't be sure what you might decide.
Best of luck, I hope this has helped somewhat.

Just for an update, my normal OB is back. He does not recommend another pregnancy. He says the chances of another rupture during pregnancy is about 1%. However my chances of having an emergency hysterecomy during a c/s is about 1 in 6. Apparently this scenaro is the most dangerous, with blood transfusions, and the possibility of other major organs being affected.

I have another appt in 2 weeks and will decide in the meantime. He is happy to do a hysterecomy in my circumstances in order to prevent an accidental pregnancy.

Now I will try and research more on emergency hysterecomy to really know what happens.

Hey there,

My opinion is varied on this...I needed a emergency hysterectomy during my son's early birth (26 weeker), I started bleeding around the scar of my previous uterine rupture (internally, we didn't know untill ds showed significant signs of distress) I needed 11 blood transfusions before I was taken back to theatre a second time (not even 24 hours after his birth) due to a Cardiac Arrest caused by internal bleeding (they found 3 litres of blood in my lungs). I now have a massive scar from the top of my chest all the way down past my pelvis

I was certainly well informed, and knew my chances of carrying my son to term after a previous rupture were limited to say the least, for me personally it was worth the risk..in saying this did I ever think things would go so badly..of course not, if you spoke to my dh he would never take the same risk again, I now live with a life-long heart condition due to the complications surrounding the emergency hysterectomy.

A hysterectomy is major, major surgery and I know first hand can cause many complications, my Ob has always said a hysterectomy should only be performed as a very, very last resort..when no other options are viable and should almost always be avoided during childbirth because of the high incidence of internal bleeding.

You would know how quickly Dr's work once a rupture is diagnoised, its basically the same stress iykwim..there is alot of risk to you and your baby, and then there is the added worry of carrying to term. (I have not heard of any Ob that will let a woman pass 32 weeks after a previous rupture) The risks are too high for a repeat. Its a big concern.

Good luck in your descion.

Peta.

Hi Peta.

You know you are the only person I've located anywhere online who can provide first hand experience on this. I REALLY REALLY appreciate your reply.

I've seen my OB again and I'm still undecided. He is a stats man, and has given me this:

My chances of rupture during pregnancy is 1/100.
My chances of me or bubs dying are 'low'.
My chances of needing a hysterectomy are about 1/6.

He has definitely said that having an emergency hysterectomy is major surgery, and there are risks to other major organs, but he didn't really explain what and why there are risks. I've put it on my questions to ask list.

He hasn't said that he would have to deliver as early as 32 weeks, but he did say 37-38 weeks. He said that contractions can cause the rupture hense why they do a c/s early. But he also said that braxton hicks may also cause the rupture. This is another thing I need to ask about, as I had BH from 30 weeks.

Overall he recommended against it, but I wonder sometimes if it's because they don't want the risk. He didn't go overboard and tell me I'm crazy, but I think I am for considering it.

It all sounds terrible as I write it, and I wonder what I'm thinking to even consider it. But my maternal instincts are in overdrive, and I feel like I want another baby. Lucy is only 3.5 months old. After Cody 7 years ago, I said "never again" for 3 years!!! He wasn't even a difficult baby - I was just an awkward first time mum.

He also said that I can have an IUD inserted carefully with ultrasound, but this in contrary to what his "fill in" OB told me!!

Hi Lois...

Ohhh yes the stats are very familiar

I shall pm you the information I was given to help make our descion:)

Lois,
I do understand your dilemma. That maternal urge is undeniable isn't it!
If it is any help to you I just want to say that I have looked after a few women in labour who have had previous ruptures and whilst I can not remember the outcome for all of them, I do remember a couple. One mum had another rupture but because we were absolutley prepared for anthing to happen, she was in theatre and delivered in 10 minutes. Mum and babe well---she did have a hysterectomy though as she had finished having babies.
The other couple I can recall were both delivered at 37 weeks, everything going well and no need for hysterectomy.

It is hard to advise as nobody can truly predict which way you will go but the important thing is to trust your OB that he will do the right thing by you.
In the stats you gave regarding the need for a hysterctomy it pays to remember that 5/6 won't need one.

Wishing you the very best luck

Hi there i had my uterus rupture during labour. Was totally unexpected, had no signs of an impending rupture. just happened.

Resulted in losing our son and nearly losing me as well. I was lucky to come out of it all ok with my uterus repaired.

We have gone on to have another baby.... not planned but not avoided either. Was a very very scary pg. Had constant monitiring and weekly ultrasounds from about 24 weeks.

The plan was to deliver via c section at 36 weeks but my scars from the rupture all thinned out to just a milimeter. So we delivered at 34 weeks. Bubs has issues breathing and was put on life support.... CPAP and given surfactant... 2 weeks later all was well and we were home.

So yes delivery after rupture is possible. My ob has even said there is no reason not to have another in the future but i must have at least 2 years for everything to heal properly. Only had 3 months between my rupture and our suprise conception.

Any way if you do decide to go ahead just be prepared for a pregnancy.... filled with stress and loads of bed rest and light duties. I was not allowed to do anything from 20weeks on wards. The most i was allowed to do was drive my daughter to school and back.... I swear i had an imprint of my lounge on my back side by the time i delivered.

Any way good luck with your decision... as for me There is no way i would consider another pg. Was lucky to come out alive after the rupture and the stress of the following pg was just increadible.

Thank you to everyone who replied to my post.

I have decided to keep my uterus and keep my options open. Now that the decision is made, I don't feel so much overwhelming need to have another baby, however I still might if the finances allow it!!!

Although my OB advises against another baby, he will support me if we decide to do it again. I'm having an IUD in January with the guidance of ultrasound to be sure that another rupture is not caused. Then I'll just relax and enjoy the next few months at home with Lucy before going back to work.... !!!!