It is possible to have a second child with uterine scar diverticulum, but it should be monitored closely during pregnancy.
Uterine scar diverticulum is caused by poor healing of the uterine incision after cesarean section in the lower uterine segment, resulting in a weak lower uterine segment where the incision muscle layer, endometrium, and plasma layer protrude outward in a hernia sac-like pattern and form a diverticulum.
If the second pregnancy is a uterine scar diverticulum pregnancy, due to the thinness of the uterine lining in this area, it may lead to a higher risk of bleeding during pregnancy, and may also lead to uterine rupture and other life-threatening conditions. Therefore, an ultrasound is needed early in the pregnancy to rule out uterine scar pregnancy. If uterine scarring is present, the pregnancy needs to be terminated promptly.
After the exclusion of uterine scar pregnancy, the fetal weight needs to be controlled. Since the uterus is weak in the area of uterine scar diverticulum, the risk of uterine rupture in late pregnancy is increased if the fetus is too large.