Follow-up after cesarean pregnancy must necessarily be planned, and it is undesirable for her to initiate during the first 2 years after the cesarean section. It is 2-3 years that will be needed in order that the scar on the uterus after the cesarean has come to a state that allows to take the baby again. For the first year, it is advisable to conduct a study of the uterus in order to follow the condition of the healing of the scar. Such a study is performed either by hysterography or by hysteroscopy. Hysterography provides an opportunity to assess the condition of the rumen with the help of X-rays, which are made after the introduction of a special substance into the uterus. Hysteroscopy involves a visual examination of the scar with an endoscope, which is inserted into the uterine cavity. When planning a re-pregnancy, hysteroscopy becomes a necessity: it allows you to determine from what tissue a scar has formed.
The scar, formed from muscle tissue, is the most favorable for the onset of a repeat after cesarean pregnancy: fully restored muscle fibers will ensure the planned stretching of the scar during the growth of the uterus. If the scar is formed from connective tissue, this fact will pose a great danger to the health and life of the mother and the fetus: with such a scar, that it will disperse during the enlargement of the uterus.
A planned pregnancy after a cesarean section requires the expectant mother to pay special attention to her own condition. In addition to the fact that it is necessary to limit physical activity and rest more, regular visits to the doctor who leads the pregnancy will also become a necessity. Particularly considerate mother should be in the third trimester of pregnancy: it is at this time the baby is actively growing, and therefore complications of pregnancy are possible. If during this period doctors are asked to go to the hospital, perhaps it makes sense to listen to rational advice.
From 35 weeks of gestation to a future mother, it is necessary to carry out a study of the scar on the uterus using ultrasound with a special vaginal sensor: this procedure is needed to assess the consistency of the scar and the possibility of natural delivery. In addition, to examine the scar doctor will be a finger method - for his soreness. Ultrasound will give an opportunity, in addition to evaluation of the scar, to also estimate the size of the fetus, its position, location of the placenta relative to the internal uterine throat and scar. According to these indicators, it will be possible to conduct births naturally.
Natural delivery after a caesarean section is considered preferable. Therefore, if there are no contraindications to delivery in the natural way, it is better to give birth independently. The argument in favor of a second cesarean may be too long a gap between pregnancies (10 years and more) - due to the age of the mother.
If the issue of births is decided in favor of the natural appearance of a baby, then the birth will definitely be planned. That's only hospitalization of a pregnant woman is best done a little earlier than the scheduled delivery. And here the opinions of specialists about how to conduct childbirth differ. Often pregnant, hospitalized in advance to the maternity hospital, on the term of planned birth pierce the bladder and stimulate labor activity. Such steps, doctors explain, help to cause childbirth in the daytime - when all specialists are in place and in full readiness: if there is a need for an urgent cesarean section. Opponents of induced births object: the only mortal danger in this case is the risk of rupture of the uterus along the rumen. But it is reduced to a minimum, if the opening of the cervix is ??smooth - that is, during the time of natural birth without medical intervention.
If nevertheless the repeated cesarean section for any reasons could not be avoided, the doctor is obliged to offer the woman a sterilization - bandaging of the fallopian tubes. Such a procedure becomes a necessity after 2-3 caesarean sections: 3 such operations are considered a permissible maximum. Each subsequent cesarean is not only becoming more difficult for the surgeon technically, but also poses an ever greater threat to the health and life of the baby and mom.