my gynae's reply.. :)

Dear Nurul Syazrah,

1. of course I remember you. Yesterday we were having great fun delivering a total of 15 babies here. (uish,ramai target date 11.11.11 tu..doc ckp 9 out of the 15 are delivered tru surgery..i wud've added up to the statistics if i didnt postpone my surgery date..;) hehehe.. )

2. Since I started my O&G practice in 1989, I have seen few deliveries after 2 CS, but they were all premature and small babies. And they were not planned to undergo vaginal deliveries, the others came late in labour.

3. As a woman, I understand your feelings wanting to undergo a normal birth. ( sweeeeeet, ;)) )

4. In modern medicine practice, the last thing we want is to add any risk to our patients. A vaginal delivery carries higher morbidity and mortality to both you and your baby.

5. Looking back at your notes, Dr M*rlik has to do adhesiolysis during the second CS meaning that your operation was not straight forward. In our guideline, only uncomplicated CS may be allowed for short trial of scars.

6. I suggest that u come for CTG test when u have the pain or 'hardening' so that we can assess your situation.

Take Care!

hurm...Let's google adhesiolysis, the culprit.

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Adhesions from previous Caesarean deliveries severe enough to require adhesiolysis during repeat Caesarean delivery have clinical and economic implications

"Adhesions are a significant complication of surgery. C-sections are increasingly common in the United States, and anywhere from 30% to 50% of patients have adhesions," explained Michael Broder, MD, from the University of California at Los Angeles School of Medicine. He estimated that treating complications of adhesions related to Caesarean deliveries that are severe enough for adhesiolysis costs $25 million to $30 million per year.

For patients who underwent adhesiolysis, compared with those who did not, the extra cost was $300 per patient ($5739 vs $5448), the operative procedure was 10 minutes longer, hospital stay was several hours longer, and postoperative complications were more common (hemorrhage [1.7% vs 1.2%], wound complications [1.4% vs 0.7%], pelvic organ damage [1.0% vs 0.1%], and hysterectomy [0.3% vs 0.1%]).

In an interview with Medscape Medical News, Dr. Broder said that the study implies that surgical technique should be improved for primary caesarean deliveries to avoid adhesions.

David Archer, MD, from Eastern Virginia Medical School, in Norfolk, disagreed. "Meticulous surgery will not decrease the adhesion rate," he said. "Many C-sections are for emergencies, and emergency surgery increases the chance of adhesions."

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meaning i got adhesions when/after delivering my first child. now whatgedeheck is adhesions?

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Adhesions are fibrous bands^[1] that form between tissues and organs, often as a result of injury during surgery. They may be thought of as internal scar tissue that connect tissues not normally connected.

While some adhesions do not cause problems, others can prevent muscle and other tissues and organs from moving freely, sometimes causing organs to become twisted or pulled from their normal positions.

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oklar..next time org tanya why i c-sect again, i can explain to them using all these medical jargons.. hahaha.. ;)

Oh, i'm so glad my doctor actually responded!! :))))