Monday, June 18, 2012

Ask Us Anything: I Had a Myomectomy and Am Pregnant. Do I Need to Deliver by C-section?

"I had a myomectomy surgery last year. I am now pregnant and I am informed that my delivery will be by c-section. Will other pregnancies will be by the same or can I go through VBAC (Vaginal Birth after C-section)?"

Dr. Lynn-Marie Aronica Responds:

The reason for for your first C-section after myomectomy is the same reason for all of your pregnancies.

A myomectomy is the removal of a fibroid, the benign overgrowth of the muscle layer of your uterus. Without knowing the extent of your surgery, I can only guess that this muscle layer was disturbed and weakened by the removal of your fibroid. This is why you have been counseled to have a C-section with this pregnancy.

VBAC, or vaginal birth after C-section, is a generally safe mode of delivery for mothers wishing to labor with subsequent pregnancies. The decision for VBAC is coordinated with a physician who will review the reasons for the first C-section. In many instances, it is a great option. However, in your case, that muscle layer would now have two weakened areas – from your myomectomy and your first C-section. Therefore, VBAC is not an option for you.

Congratulations on your pregnancy and know that you and your physician has made a safe choice to keep both yourself and your baby healthy.

– Dr. Lynn-Marie Aronica

Dr. Lynn-Marie Aronica is board certified in OB/GYN. She sees patients at her office at the Mercy OB/GYN Center in Buffalo. Her interests include family-centered obstetrics and high-risk obstetrics. 

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  1. I had a Myomectomy over two years ago and am in the process of trying to get pregnant for the first time now. Is there a possibility of delivering vaginally for the first pregnancy after the surgery? Or does it always have to be a c-section even though its been years since my procedure?

    1. Alyssa,

      Most physicians agree that prior uterine surgery is an indication for a C-section. However, not all patients are alike, and I would discuss the mode of delivery with the doctor who did your surgery.


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