Monday, March 21, 2011

Nicked Uterine Artery During C-Section: Is It Serious?


Question:

Hi there. I am a "mostly" healthy 30 yo female, G2 P2, with chronic HTN, obesity, and history of 1 run of VTAC 5 years ago which was deemed idiopathic in nature. History of pre-e w/baby #1... induced labor, emergent c-section due to fetal decels and failure to progress. Baby #2 was attempted VBAC, which ended in a crash-c.

During the crash C-section, the surgeon nicked my uterine artery. He had a hard time getting the bleeding to stop and I was close to getting transfused. The surgery took 3 hours. He joked with me about having a "metal clamp" on my uterus permanently, but I don't need to carry a card with me to the airport to get through metal detectors..., but I was so out of it, I never got any education or clarification. Is a nicked uterine artery a big deal? It's been 2 years post baby/surgery... should I be healed by now? Is there a possibility I really do have a metal clamp in me? What are the ramifications of a nicked uterine artery... can this lead to infertility and/or problems down the road with trying to conceive and/or childbirth?

Thanks! J. from the U.S.

Answer:

Hello J. from the U.S.,

In answer to your questions:

1. No a nicked artery is not a big deal if it was repaired. In fact, the uterus is so resilient with blood supply, that you could tie off or remove the two uterine arteries and it still will function just fine.

2. The metal "clamp" he is referring to is probably a vascular clip, which we use a lot in surgery. It is usually a very small titanium clip and will not affect anything.

3. You should be healed from the surgery as of 8 weeks post surgery.

4. Yes, you probably have a metal clamp inside, as explained above.

5. I answered this last question in answer #1. Not to worry, there are no long term consequences to this problem.

Glad that baby #2 was delivered healthy despite the emergency and you are well! Congratulations!

Sincerely,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

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