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ObGyn/Pregnancy issues/Uterine defect near c-section scarring


I am pregnant with my 4th baby after 3 c-sections.  After the third, I was told I had a thinning lower segment and I had not healed well.  
I'm now 22 weeks and high risk for issues not related to the previous c-sections.  Yesterday, my dr found a "thinning defect" on my uterus near my c-section scarring.  To me, it looked like a pocket sticking out where it would usually be a rounded edge of the uterus and it made for a strange shape on the ultrasound. My fluid levels are also high.  The dr is concerned because I'm only 22 weeks and there is already an area of visible concern.
I have an appointment for further ultrasounds in a week.

What can I expect in this situation, being that it is so early?   Complications in past pregnancies have been PPROM @ 22 weeks w/delivery @28 (unknown cause), cholestasis, irritable uterus and preterm contractions, polyhydramnios (unknown cause).  I am taking p17 injections, magnesium oxide and have been on modified bedrest.  My second and third pregnancies carried to 37w.
My dr mentioned complete bedrest.  Is hospitalization warranted in a case like this?   I'm terrified of a uterine rupture.  Would medication to reduce fluid levels and reduce pressure on the uterus be helpful?   What are my chances of carrying to at least 36 weeks?

Thank you for any help you can provide!!


Although this is a complicated situation, the outcome can never be predicted.

The best thing to do is to have your antenatal care in a hospital close to your home with facilities for Neonatal intensive care units with well trained senior Obstetricians as the delivery will definitely be before 37 weeks.

You will also need to have more frequent antenatal visits to your doctor and more frequent ultrasound examination to follow the progress of the defect.

Good Luck  

ObGyn/Pregnancy issues

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Mohamed Kandeel


I can answer questions about antenatal care, medical problems associated with pregnancy, labor and delivery and postpartum care.


Currently I am working as a Professor of Obstetrics gynecology, Menofyia University, Egypt. Since 1987, I worked in many university and private hospitals with a high load of pregnant population averaging 7-9,000 deliveries/year. This exposed me to all problems associated with pregnancy, labor and delivery. I had my doctorate degree in Obstetrics and Gynecology in 1996 in the use of Doppler ultrasound in high risk pregnancies.

Menofyia University, Egypt

-British Journal of Obstetrics and Gynecology (Kandil M) -Egyptian Journal of Obstetrics and Gynecology (Kandil M) -Ain Shams Journal of Medicine (Kandil M)

-Master's degree in obstetrics and Gynecology 1989 -Doctorate degree in Obstetrics and Gynecology 1996

Awards and Honors
Editorial advisor: Fetal monitoring section of the international website

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