Is it possible to make a fourth cesarean section? Reviews and opinions of doctors

The fourth cesarean section in Russia, and in the world, is done infrequently. However, the absence of widespread widespread practice does not mean a ban for the mother of three children, who appeared due to the efforts of the surgeons, to have a fourth child.

True, such a pregnancy, of course, will have its own characteristics, and the operation will be somewhat different from previous ones. In this article, we will look at the likelihood of the fourth cesarean section and the risks associated with it, as well as analyze the opinions of doctors.

Modern medicine can conduct and 4 operations, and 5, and 6, and as long as required. But the risks to the life of the mother and the fetus, for their health, with each subsequent "royal cut" (translation "Cesarean section" from Latin) will increase significantly.

Not so long ago, even two cesarean sections caused confusion among doctors. Then they began to do three operations without question, and women, who for some reason give birth with the help of a surgeon's scalpel, were given the opportunity to be many children. They were deprived of this opportunity until the beginning of our century.

Now the fourth cesarean section is performed, because medicine has at its disposal ample opportunities in the application of new surgical tools and materials, but the woman is still at the registration stage in consultation must be warned about what risks her decision to preserve and carry the child can be associated with, what complications encounter during surgery and in the postoperative period.

The main danger lies in the probability of uterine divergence along the scar. Each subsequent cesarean section is performed along the old scar, each time the surgeons have to excise it in order to put a new stitch. Therefore, after three cesarean sections, it is rare for a woman to boast a wealthy and reliable scar in the uterus area.

The reproductive organ grows as the baby grows, its walls stretch, and the scar also stiffens. because the risk that it will not stand and burst, with each subsequent pregnancy increases. The consequences can be tragic - in most cases, the child and the mother die.

Because of the scar tissue in the uterus, the probability of abnormal attachment of the placenta increases, which is fraught with a delay in intrauterine development of the fetus, its developmental defects, hypoxia, and premature detachment of the "baby". With each subsequent operative delivery, the probability of a total increment of the placenta to the uterus in the area of ​​the rumen increases, if part of the “children's place” goes to it. In this case, childbirth ends with the removal of the uterus, since it is not possible to separate the afterbirth with total ingrowth.

This is what a woman is advised to consult in when she comes to get registered for the fourth pregnancy after three cesarean sections in history. Many do not withstand the oppression of prospects and agree to an abortion. Those who remain firm in their intention to give birth gradually begin to realize that everything is not so scary.

Even if the scar was initially not very ideal after three cesarean sections, and the doctors doubted its viability, that is, clinics and doctors who specialize in managing such pregnancies. If desired, even with a problem scar, a woman can carry a baby.

The technique of operation is not very different from previous interventions, but the fourth cesarean can last longer because of the need for excision and removal of old adhesions and uneven connective tissue.

In the postoperative period, the woman especially needs the use of contractile drugs, because the walls of the uterus are over-stretched after 4 bears, and if there is a fresh scar, they are extremely badly reduced.

Otherwise, there are no significant differences. Hospitalization should be planned at 37-38 weeks of pregnancy. If signs of insolvency of the scar and the threat of rupture are noticed (and it is necessary to monitor it by ultrasound every 10 days in the third trimester), the operation can be carried out earlier.

According to doctors, there is nothing unusual in the fourth cesarean section. As in the fifth, and even in the sixth. But now the modern health care system, which requires much from the doctor, sometimes leaves the doctor no choice. In order not to be responsible for the possible consequences, if the scar on the uterus is not too good, the doctor has to offer the abortion to the pregnant woman.

Another approach in clinics that take on such pregnancies (usually for a fee). There, a woman can really be encouraged and given hope, especially since doctors perfectly understand that the fourth cesarean can and should be done, and many dangers can be avoided by careful observation of the future mother's condition.

There are not so many reviews of the patients themselves on the Internet, since only a few are decided for the fourth birth through the CS. The author of this article is one of those who decided and did not regret their decision.

Moms share their experiences in the next video.