Possible complications after an extra-intra-intra-cesarean section

The article was consulted professionally by Master, Dr. Le Nhat Nguyen – Obstetrician and Gynecologist – Share99 DaNang InternationalHealth Hub.

Extra-in-uterus is usually prescribed surgery in case of late detection of diseases such as rupture of the uterus, causing a lot of bleeding. After treatment if the treatment is not followed and the doctor's advice can cause a number of complications such as high fever, abdominal pain, wound bleeding, worsening the condition of the incision, slowing down the healing process.

Extra-intra-uterus pregnancy is the phenomenon of mis-nesting pregnancy. The exact nesting location of the pregnancy is in the uterus chamber. However, due to certain causes, the fetal mass does not move down the uterus, leading to nesting in other locations such as the proboscis, ovaries, cervical tubes or other places in the abdomen, even outside the peritoneal cavity. It is estimated that up to 95% of extra-in-uterus occurs in the proboscis of the uterus (55% in the speakers, 25% at the waist, 17% in the glossy segment and only 2% in the interstitial). Only the remaining 5% nest and grow in other locations. The fact that the pregnancy is not nested in the right place causes many dangerous effects on the health, even the life of the mother.

2.1 Symptom-based diagnosis

Symptoms that help detect early detection of an extra-intra-uterus pregnancy include:

• Manifestations of abdominal pain: The location of pain in the hypoth hypothxia, pain of a smoldering nature, sometimes into a bout
• After a few days of slow menstruation, there is less blood, blackish-brown color sometimes mixed with

When the outer uterus has ruptured, the symptoms of the disease are rampant, forcing the patient to be admitted to the hospital for timely treatment to avoid dangerous complications. Symptoms include:

• Sudden, severe abdominal pain, which makes the person sweat
• Symptoms of emergency blood loss: Blue skin, pale mucous membranes, cold limbs, rapid pulse, blood pressure drops.

2.2 Diagnosis based on subclinical testing

• Dosing βhCG blood: Over 60%, pregnant women with βhCG levels double after 48 hours. If the amount of βhCG does not increase so in combination with an ultrasound that does not see the pregnancy in the uterus, it must be suspected of extra-intra-uterus.
• Serum progesterone: Lower levels of progesterone in the extra-uterus. If progesterone levels < 5ng/ml thì có nghi ngờ thai bất thường. Other tests should be combined for accurate diagnosis.
• Ultrasound through the abdomen and vagina: Abnormal ultrasound results such as no picture of the amniotic sac in the uterus chamber, there is a hemoping echo area, clear boundaries, small size next to the uterus.

Ultrasonic Doppler: Ultrasound results show signs of ring fire. In rare cases larger-sized mass can be seen, there are echo images of pregnancy and fetal heart activity outside the uterus.

There are 2 methods of extra-intra-intra-uterus surgery:

• Laparoscopic surgery: Is the preferred method in the treatment of extra-intra-uterus surgery. Surgery has advantages such as leaving small incisions, short hospital stays and high aesthetics. Especially it is possible to preserve the proboscis of the uterus, which is necessary for women who still intend to give birth.
• Open surgery:Open surgery applies to the ruptured extra-uterus mass, there is too much blood in the abdomen, among other causes.

• High fever

High fever occurs as a sign of inflammation. In addition, high fever is also the cause of the incision has not healed, the bung has not healed completely. If the patient is accompanied by other manifestations such as discomfort, fatigue, dizziness, it is necessary to go to the doctor immediately.

• Swollen incision

Swollen incisions accompanied by heat, redness, pain can occur due to infection, bumps only. This sign also leads to bleeding that has serious consequences for the person. Therefore, the woman needs to take care of the wound carefully, avoiding infection of the wound.

• Abdominal pain

Abdominal pain can occur because the incision has not healed, swelled, the podium only causes bleeding that endangers the patient's life.

• Incision bleeding

Endoscopic incision bleeding is a dangerous complications. If bleeding quickly and multiple can be fatal for the person. Therefore, the woman after surgery should monitor her health regularly to detect abnormalities as a timely precaution until full recovery.

After the period of extra-ervical cesarean section the woman needs time to rest. In addition, it is necessary to strictly follow the advice of the doctor including:

• Do not over-labor, participate in physical activities
• Take time to rest, relax your mind
• Nutritious diet, adequate supplementation and coordination of greens, fruits and foods such as eggs, fish, pork, chicken. Avoid eating some hemorrhagic foods such as ginger and some other foods such as aloe vera, green papaya, seafood.
• Do not drink alcohol, beer, do not use stimulants
• Do not have sex until the wound fully recovers
• Comply with the doctor's prescribing of therapeutic drugs, do not buy the drug for use on their own

Pre-birth screening helps pregnant women detect pregnancy complications early for timely intervention. Department of Fetal Medicine – Share99 International Health Hub is the first unit in the North to deploy a 1-door pre-maternity clinic (OSCAR) to provide a comprehensive screening package for 12-week pregnant women. The clinic returns results quickly on the day of the examination and the screening is carried out.

The Faculty of Fetal Medicine has successfully implemented advanced pre-birth screening methods, helping to screen for complications for obstetrics and gynecology; Timely detection and intervention of some fetal abnormalities such as an extra-intra-uterus pregnancy from very early weeks of pregnancy.

Dr. Le Nhat Nguyen has more than 20 years of experience in the field of Obstetrics and Gynecology. Dr. Nguyen is a former obstetrician at Gia Dinh People's Health Hub in Ho Chi Minh City. BS has high expertise and strengths in the diagnosis and treatment of obstetrics and gynecology diseases. Currently a Doctor of Obstetrics and Gynecology Department – Share99 Da Nang InternationalHealth Hub.