Thinning uterus???

Kenda&Rain

Hi. I was wondering if any other moms with previous c-sections have had issues with a thinning uterus at the incision site? I've had two previous c-sections (1999 and 2007) and was hoping for a VBA2C. I am currently 30 weeks. We were planning on scheduling a c-section, and initially the plan was that I would be allowed to try vaginal if I went into spontaneous labor prior to the scheduled c-section. Since about 27 weeks I've been experiencing braxton hicks contractions, but they've actually been somewhat unpleasant and didn't stop with movement and activity. At 29 weeks I experienced leakage or something (they weren't able to definitively say whether it was amniotic fluid or what) after work. I am an aerobics instructor and was teaching a class. That same evening I experienced sharp pain across my lower abdomen, it had me doubled over. Long story short, vaginally everything looks fine, baby is great. However, upon further inspection at my MFM office they determined I have a thinning uterus at the previous incision sites, and the contractions were causing it to get thinner. So I am now on restricted duty - early hiatus from teaching my aerobics classes, no teaching swim lessons because the warm water pool makes the contractions increase, and limited daily activities. They've also told me that there will be no chance of me being allowed to go into labor and they'll be taking the baby earlier, although the specific time hasn't been set yet. I am concerned. Dr says I'm lucky because we caught it early. Apparently most cases aren't seen or noticed until they go in for the c-section and it's seen upon opening, or upon rupturing. If I experience any more of the lower abdomen pains I am to go into L&D IMMEDIATELY. 

I am MUCH healthier than when I had my previous two (280 pounds lighter!), no diabetes, bp is great. This is NOT how my last pregnancy was supposed to go. I'm wondering if anyone else has had this sort of experience and had it caught early. 

missmodeste

No experience here.

But, how did your MFM dr determine a thinning uterus? Did you have a baseline to start with that they are now comparing it to?

EmR22

I had an actual window in my uterus but they didn't discover it until I had my DS which was my 3rd c section. My OB said the only thing holding him in was my bag of waters. I was told I can not have any more children because of this.  

I'm glad they caught yours before something happened but what a stressful situation. I wish the best for you and LO.

Kenda&Rain

There was an ultrasound done internally/vaginally. Plus they have ultrasounds from 4 weeks and on that were done vaginally also. They were able to see that part of my uterus. Apparently the pain that I described to the doc when I called in when I had the pain and the leakage clued her in to looking closer since everything else was okay. 

EmR22, my dr said that is generally what happens, it's usually found after the birth of the baby when done via c-section. I'm glad that caught it for you at that point and that everything worked out with your DS. 

AshleaB12

I attempted a VBAC in May and after I had pushed for about an hour, I started having terrible abdominal pain that the epidural wasn't touching and began constantly vomiting from the pain. I refused to push anymore because I swore something was wrong. I requested a c-section and when the OB opened me up, I had a uterine dehiscence and she said she could actually see my son as soon as she opened me up because my uterus was transparent in the thin area. She said she could see his arm moving around. She advised me not to have any more children and if I did I would need to deliver by c-section at 36 weeks. She recommended a tubal which I reluctantly agreed to and now regret.

Kenda&Rain

Good for you to stand your ground! That sounds like a horrible thing to have to go through :-( I'll be having my tubes dealt with while they are in there for the c-section, but I went into this pregnancy knowing it'll be our last one. I'm sorry that you didn't have the time to think through that decision. 

AshleaB12

Thanks. I'm seriously bummed about the tubal. I'm incredibly thankful for my two healthy kids but I always envisioned a larger family. I have considered a reversal but I'm scared. She told me I could die if I were to get pregnant again but my regular OB told me that I probably would have been ok the next time and that we could have monitored the thin spot with ultrasounds which she never once mentioned. You talking about having braxton hicks contractions that wouldn't go away sounded similar to my experience. One day I had contractions that were as bad as labor at 28 weeks. I ended up in triage. They ran some tests and gave me tons of IV fluids and they slowed down a lot. I had them for a whole week after that. They were really painful. This happened around 36 weeks too but I just drank boatloads of water and eventually they slowed enough that I wasn't in terrible pain. Now that you say that, my husband and I had wondered if those episodes of very painful contractions were part of what led my scar to thin out.

lkf041

Me.  With my 2nd baby, during surgery, the uterine window was discovered.  I held her to term (40 weeks exactly) with no problems.  I got pregnant 9 months after having her (no one told me not too).  At 32 weeks with my 3rd baby, the window was still there and had herniated.  I was put on hospital bed rest and then sent home until delivery at 37 weeks.  I was told a 4th could still be a possibility as long as I'm monitored throughout. 

AshleaB12, I would consult a lawyer for malpractice.  Forcing someone to have a tubal without knowing all the facts is ground for a lawsuit. 

AshleaB12

We are actually in the process of looking for one now. I definitely don't feel like she told me everything she should have and actually I declined the tubal twice and then the longer the surgery took, the more scared I got and eventually said yes. I think a good surgeon would have said, "you really don't seem sure of what you want to do, lets just wait until you discuss it with your regular OB at your 6 week check up". The nurse anesthetist even told me in recovery, "I don't know what her problem was, she was awfully pushy". Now that the idea is in my head, I'm kind of afraid if I did have a tubal reversal or IVF to get pregnant again that I really may die.

EmR22

AshleaB12 said:

We are actually in the process of looking for one now. I definitely don't feel like she told me everything she should have and actually I declined the tubal twice and then the longer the surgery took, the more scared I got and eventually said yes. I think a good surgeon would have said, "you really don't seem sure of what you want to do, lets just wait until you discuss it with your regular OB at your 6 week check up". The nurse anesthetist even told me in recovery, "I don't know what her problem was, she was awfully pushy". Now that the idea is in my head, I'm kind of afraid if I did have a tubal reversal or IVF to get pregnant again that I really may die.

And that's why my hospital makes you have your tubal orders on file for 60 days prior. Even in my bad situation if I had asked she would not have done it. I'm so sorry you are going through this. It's like a betrayal of trust.

AshleaB12

I wish she would have never asked me. Every person I have talked to had to sign papers way in advance for their tubal. My SIL's sister even brought it up to her OB at her 6 week check up after having her second baby and he wouldn't even entertain the idea of doing it. He suggested her husband have a vasectomy. I didn't trust this OB in the first place but she was the one who was on call that day and I didn't want to make a big stink about it on a Sunday (weekend). My OB knew I didn't care for her and had said if she was on call when I went into labor that I could ask the nurse if there was another doctor in the practice who could come in for me. I now wish I would have asked for someone else. I told my DH that I have no doubt in my mind that if my regular doctor had been on call that none of it would have ever happened.