I’m looking for advice/experiences from women who have had a similar situation involving a uterine window/dehiscence, myometrial defect, uterine perforation or a complicated previous caesarean.
I’m currently 26+5 weeks pregnant and my current plan is an elective C-section around 37–38 weeks. I’m wondering whether I should be advocating for a further discussion with my obstetric team about whether an earlier planned C-section (around 35–36 weeks) should be considered.
My history:
* In 2019 I had a D&C complicated by a uterine perforation in the fundal/top area of my uterus.
* In my 2022 pregnancy, I PPROM’d at 30 weeks and delivered my son via emergency C-section at 32+5 weeks. He was 1977g and spent 20 days in NICU (I had received steroids beforehand).
* During that C-section, the surgeon documented a “serosal bulge” and an “area of myometrial defect” from the previous uterine perforation. The serosa was intact, but the area was carefully inspected.
* I was told the uterine window/defect could not be repaired at the time because it was a weekend emergency C-section situation.
* I now also have a separate lower uterine segment scar from that C-section.
* In this pregnancy, the previous fundal defect is difficult to visualise on ultrasound because of its location, so it cannot really be monitored.
* I also have hypermobile Ehlers-Danlos syndrome and other connective tissue/structural issues.
My current baby is measuring around the 70th percentile (around 850g at 25+0 weeks), and I’m worried about continuing to 37–38 weeks because my uterus was already showing a bulge/defect at 32+5 weeks with my son, before reaching term. I understand growth measurements aren’t the only factor, and I also understand there are risks with delivering earlier… I just want to make sure my individual risk is being properly considered.
I feel like I haven’t really advocated for myself and have mostly just accepted the recommended timing without questioning it.
For anyone who has had a similar history:
Did you push for an earlier elective C-section?
Did you get a maternal-fetal medicine/senior consultant review?
How did your team decide the safest timing?
I’m not looking for medical advice from strangers, just experiences and whether others felt they needed to advocate for a different plan. ❤️