Due to the high rate of cesarean sections in China, people are no longer familiar with scarred uterus. With the implementation of the “two-child” policy, scarred pregnancies, which are known to be dangerous, are also becoming familiar to people. What should I do in case of a scarred pregnancy? Most doctors, not just pregnant women, believe that the pregnancy should be terminated as soon as possible. However, the truth is not absolute, even in the case of a scarred pregnancy, it does not have to be terminated. As long as the entire pregnancy is monitored by a doctor, it is possible for a scarred pregnancy to pass through the pregnancy and be delivered safely. However, it is important to rule out a scarred pregnancy in any woman who has a scarred uterus and is pregnant again. What is a scar pregnancy? The fetus is in the scar of the uterus To find out what a scar pregnancy is, it is important to first find out what a scarred uterus is. After a woman has undergone surgery such as a cesarean section or myomectomy, her uterus will be scarred, also known as a scarred uterus. However, not all scarred uteruses will experience scarred pregnancies. It is only when the fetus happens to be laid in the scar of the uterus that it is called a scar pregnancy. Not all pregnancies after cesarean delivery will result in scar pregnancy. It is important for women who have had a history of cesarean delivery or uterine surgery to rule out the possibility of scar pregnancy after another pregnancy under the guidance of their doctor. Scarred pregnancies show little difference from normal pregnancy during early pregnancy, with the same history of menopause, enlarged uterine body, positive blood and urine HCG, and other normal early pregnancy signs. The only way to detect a scarred uterine pregnancy is through ultrasound. In addition, a pregnant woman with a scar pregnancy may also have irregular vaginal bleeding after menopause. It is important to be alert to this situation. Traditional view: Once a scar pregnancy is diagnosed, it must be terminated as soon as possible Scar pregnancy is a type of ectopic pregnancy and is often referred to as a rare but exceptionally dangerous obstetric emergency. It may cause the following consequences: 1. Due to structural abnormalities, the tissue at the uterine scar is weaker than normal tissue, and as the fetus grows, the uterine scar is easily torn open, which may lead to uterine rupture if the pregnancy continues; 2. It may easily lead to placental implantation, which may cause hemorrhage during delivery, and in serious cases, the uterus may need to be removed, even endangering life. It is known that in the obstetric cases of hysterectomy due to severe bleeding, 20% to 30% are related to scar pregnancy. Therefore, so far, it is the opinion of many obstetricians that the pregnancy should be terminated as soon as the embryo is diagnosed to be implanted on the uterine scar. The main reason for this is that scar pregnancy after cesarean delivery is indeed a very dangerous type of pregnancy with the potential for great risk. The latest opinion: scar pregnancy can be delivered successfully with close monitoring by doctors With the advancement of scar pregnancy management technology, scar pregnancy is now not as scary as people think. As long as the thinnest thickness of the uterine plasma layer of the gestational sac is greater than 3 mm from the uterine scar, the pregnancy can be safely carried to full term after the doctor’s assessment of the other conditions of the pregnant woman. Even if the fetus lays at the edge of the scar, the pregnancy can be safely monitored by the obstetrician. This entire process is within the doctor’s control. For example, the doctor will always assess the thickness of the thinnest part of the uterus, and in case there are signs of uterine rupture, the doctor will make a timely judgment and help the pregnant woman to terminate the pregnancy, and in many cases, a viable fetus can be kept; for example, placental implantation itself has no clear impact on the growth and development of the fetus, but the risk of endangering the life of the fetus and the mother due to uterine rupture and hemorrhage caused by contractions during delivery The risk of fetal and maternal life is increased. In fact, even if the placenta implants deep into the bladder wall, the pregnancy can still be continued, because the process can still be monitored by the doctor, for example, with the use of drugs that inhibit contractions and reduce the risk of uterine rupture. It is entirely possible for the doctor to repair the uterus and preserve its structure and function while the delivery is safe. This way, they still have a chance to carry another child. One pregnant woman with a scarred pregnancy reached 26 weeks of pregnancy when she developed a tear at the uterine scar and the water sac bulged out. However, she chose to continue her pregnancy under close monitoring and observation by her doctor. It was only when she showed signs of labor at over 33 weeks that she came to the hospital on medical advice to undergo a cesarean section and safely delivered the fetus. Therefore, after another pregnancy with a scarred uterus, even if a scarred pregnancy is diagnosed, it is not necessary to terminate the pregnancy simply because of the scarred pregnancy. If one decides to continue with the pregnancy, it is perfectly acceptable to undergo labor and delivery under the close monitoring and guidance of the obstetrician and to receive various active interventions from the doctor until the delivery is successful. Doctors should also not actively advocate for a pregnant woman to terminate her pregnancy unless she herself requests it. If a pregnant woman chooses to terminate her pregnancy on her own for various reasons, she must also do so under the guidance of a physician. In particular, pregnant women with scar pregnancy should not perform abortion or medical abortion at will, in order to avoid the inability to completely detach the chorion or placenta and the inability to close the blood vessels, which may lead to hemorrhage.