Women who have previously undergone a C-section and become pregnant again may face complications related to the old surgical scar. Notably, these include pregnancy at the C-section scar and placenta accreta.

However, early pregnancy after a C-section does not automatically mean the pregnancy is dangerous or must be terminated. The risk depends on the specific time elapsed between the C-section and conception, the condition of the scar, the location of the gestational sac and placenta, and the mother's health.

You should not be overly worried. It is important to see a doctor promptly after a positive pregnancy test. The doctor will determine the gestational age, the location of the gestational sac, and assess its relationship with the old C-section scar.

One critical abnormality to rule out early in women with a C-section history is pregnancy at the C-section scar, where the gestational sac implants in the uterine scar. This is a specific type of ectopic pregnancy that cannot continue safely. If the pregnancy progresses, the placental villi can deeply invade the uterine wall, potentially penetrating the serosa, increasing the risk of uterine rupture and intra-abdominal hemorrhage.

If the pregnancy is located within the uterine cavity and develops normally, the expectant mother will be monitored as a pregnancy with a C-section history. In subsequent months, the placenta's position requires monitoring. A low-lying placenta, situated on the anterior uterine wall near or covering the old C-section scar, can increase the risk of placenta previa and placenta accreta. These are dangerous obstetric complications that can cause severe hemorrhage during pregnancy or childbirth.

If placenta previa or placenta accreta causes bleeding, especially in preterm pregnancies, an emergency C-section may be necessary to ensure maternal safety. Fetal outcome largely depends on gestational age and the baby's condition.

Throughout your pregnancy, you must attend scheduled appointments and go to the hospital immediately if you experience vaginal bleeding, unusual abdominal pain, dizziness, or severe fatigue. If the fetus and placenta are in normal positions, and both maternal and fetal health are stable, the pregnancy will be monitored until the appropriate time for delivery.

Doctor Nguyen Ba My Nhi advises an expectant mother. Illustration: Tam Anh General Hospital.

Expectant mothers with a C-section history, especially those with a short interval between pregnancies or risk factors such as placenta previa or suspected placenta accreta, will have their risks assessed by a doctor. The doctor monitors the placenta's position, fetal development, and maternal health to proactively plan for a suitable delivery.

For high-risk expectant mothers, a delivery plan is prepared in advance to manage potential hemorrhage or complex situations during surgery.

You should seek early examination and ultrasound to determine gestational age, the location of the gestational sac, and its relationship with the old C-section scar. From this, the doctor will develop a suitable monitoring plan to ensure the safety of both mother and baby.

Doctor Nguyen Ba My Nhi

Director of the Obstetrics and Gynecology Center

Tam Anh General Hospital System, TP HCM