QuestionHi Brenda. I am 37 years old, and 13 weeks pregnant. In March '06 I had a laproscopic
appendectomy and the surgeon discovered my uterus is adhered to my
abdomen wall. I went to see my OB/GYN after the surgery to talk with him
about it. He asked me if I was in any pain, had pain during sex, or was
needing to urinate often. I answered no to all the questions. He said that he
thought we should just leave it alone, because he couldn't guarantee that if
he went in and surgically separated my uterus from my abdomen, that it
wouldn't get stuck all over again due to scar tissue. It's stuck right at the site
of my c-section incision (I've had two c-sections). I asked him if it would
cause complications if I were to get pregnant again, and he said no. BUT, I
can't help but worry about the uterus rupturing when it gets all stretched out
and heavy from the weight of the fetus. Do you have any information on this?
I keep picturing my uterus breaking open, like pulling tape off an inflated
balloon!
AnswerDear Karen,
Unfortunately, there really isn't a lot of literature on this. I've done some research and found a June 2006 case study from the 'Journal of Gynecological Surgery' but even that study is specific to the pelvic pain that this condition causes and the treatment that was provided to alleviate the pain.
Another reference did very briefly address pregnancy related to this condition, but just stated that at times an adhesion might eventually cause the uterus not to expand as well. Typically, in that situation, doctors would be watchful for signs of preterm labor.
As far as the physiology of what happens with this, I can tell you that adhesion formation occurs after trauma to the tissues, and is caused by an inflammatory response due to tissue damage. Adhesions tend to form following surgery, inflammation, trauma or radiation therapy treatment. Many people experience decreased movement and function as well as increased tissue tension following injuries, surgeries, and infections. Like scars that form on our skin, adhesions from surgery, inflammations, or injury become "internal scars." They may become painful and sometimes inhibit proper function by adhering tissues and organs that are designed to move freely, especially organs like the intestines.
I would say that your doctor is fairly confident, in seeing the report or talking to the surgeon who performed the appy, that your chances are good of getting through the pregnancy without any major complication. I'm sure he/she will remain aware of the adhesion and be watching for any symptoms of a problem. Make sure that you report any abdominal or pelvic pain to your doctor, so that it can be determined as to whether the adhesion is becoming a factor in your pregnancy. As in any pregnancy, significant vaginal bleeding should also be reported. Otherwise, I would say it is quite possible that you could sustain the pregnancy very well. If there are any issues at all with the adhesion, it probably wouldn't be until your uterus really starts stretching in the latter months and I'm sure your doctor will stay on top of it.
I hope this information has helped you and answered your question. I know any variance from the norm causes anxiety and worry, but the stress of worrying only has negative effects on a pregnancy. I hope you can try to worry just a little less (especially picturing bursting balloons!) and enjoy your pregnancy a little more until there is something that would actually happen to warrant it. (I know - VERY hard to do!) :-) I wish you well and will have a good thought for you! Merry Christmas to you and your family!
Brenda
