Scars that strangle (4): Pregnancy and adhesions

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One after-effect which I and indeed most of the survivors of infant surgery have had no difficulty escaping is what the adhesions (so common after abdominal surgery) can add to the discomfort and pain of pregnancy.  Many congenital and other infant abnormalities of our bowels affect baby boys more often than the girls.

All of us who have had infant surgery for a bowel complaint like pyloric stenosis (by far the most common culprit) hold their breath for a few months after the birth of our offspring.  My wife and I were certainly on high alert four times for a recurrence of the trauma I visited on my parents two generations ago!  Our fourth (and last) was an enthusiastic puker for a while, but we remain thankful that this never developed into the projectile vomiting and bowel blockage I had.

I have posted three times in recent months about the distress which adhesions bring to some who have had surgery during their infancy.  This time I want to review some of what I have learnt from women who have posted about their experience of pregnancy in the light of their having had pyloric stenosis.

Understandably I’m writing this post with some trepidation… I do so as a male who has been through four pregnancies and births with my married partner of 46+ years, and just as importantly, as one who has seen serious questions raised rather often on internet forums and blogs.  Having learnt so much about the possible long term effects of infant surgery, I am passionate about sharing the issues and some of the material I have read.

So here we go…

Will my surgery and scar stop me from having children?

Certainly not.  Some few people worry about this but there is no connection between the defects of and repairs to our food passage and our ability to carry a baby.

What’s more, the old scar will not tear open or become unsafe.  A surgery scar may affect the surrounding tissue as it is stretched: it is not as supple, but after a year or two, a surgical wound has developed scar tissue which is very tough.  Massaging the scar area with a topical cream may help it become more supple than otherwise.

Will my surgery and scar affect my pregnancy?

It probably won’t – but it may.

I find it telling that I have never come across any research on this and must doubt that this important although passing possibility is given much attention.  I do imagine it must be hard to find the subjects for such a study.

Worse, I have not yet heard of a doctor who actually dealt with a patient’s clear symptoms of adhesions from upper abdominal surgery adding to the discomfort of her pregnancy.  Everybody whose story I’ve read says her doctor ignored, sidelined or brushed off her concern.  Again, I realise doctors have a schedule to maintain and must stay focused on the core reason for the consultation (in this case managing the pregnancy), but from everything I have read and experienced myself, doctors could do much better in dealing with their patients’ expressed concerns – or directing these to others more expert in the area concerned.

Something to watch out for is that several people report their doctor having blamed their pain on an inflammation of the gall bladder or caused by the liver, and I even have several reports of people having gall bladder surgery which proved to be unnecessary!  Wow!  Make sure there is a thorough diagnosis before you go too far down this path.

The good news is that adhesions in the abdomen seem to affect only a small percentage of those pregnant women who have had surgery here.  Almost all mothers with a pyloric stenosis (and other) surgery history report that their pregnancy was not affected by it very much or at all.  Several comment that there was some discomfort around the scar, but elsewhere too.  Adhesions from endometriosis, gynaecological conditions and surgery of the lower abdomen do cause many problems – but that is not within the scope of this blog.

The bad news is that for an unknown but probably small percentage of women, a pregnancy after abdominal surgery brings with it some additional problems.  As well as itching, these may include tearing, jabbing or stabbing feelings, mild or severe pain in the middle to right upper abdomen, and in some cases even some bleeding.  Certainly uncomfortable and distressing, but nothing more serious from a medical point of view.

One sufferer wrote:  The pain is at best mild, but can get worse, usually 30-45 minutes after eating.  It is constant, but I have learnt to recognise, offset and control it with painkillers.

Another mother-to-be has written:  It feels as though the scar is somehow attached to my ribs and my growing belly is pulling on it.  It feels like something is slowly being ripped inside of me, some days it is a slight ache while others it is a throbbing /shooting pain on my side.  It seems to come later in the day, as if the pull of the weight of the baby is straining it somehow.  Also, some days it feels numb and tingly, but not in a good way.

A third young woman wrote:  My scar just feels like it’s going to bust open…. The pulling, burning and stabbing pains are becoming unbearable

Will my baby have what I had?

It all depends.  On the web there are statistics on the various possibilities: only one in three or four pyloric stenosis cases is female, but a mother with a PS history is more likely (about 20%)  than a father (about 5%) to have a child with the problem.  PS can also skip a generation or two  and occur on different branches of the family tree; in some families there are many sufferers, but in my family I’m the only one so far (and as far as I know).  I plan to post more about this at a later date.

Can my baby be tested for an abnormality pre-birth?

Scans very sometimes show up “minor” defects like pyloric stenosis, but not with great certainty.  Scans may or may not show up a particular abnormality, and the baby’s later development often “overtakes” early scans.  Some abdominal defects are truly congenital (present at birth); others like pyloric stenosis almost always develop after birth (but 20% show up very early, well before the usual range of between 3 weeks and 3 months).

What can I do about the grief my scar is giving me during my pregnancy?

The short answer seems to be: Rather little.

The value of massaging and skin creams is emphasised by some and doubted by others: try it and make up your own mind!  Using mild and doctor-approved pain medication in later pregnancy is probably the best course.  It is sensible to keep weight gain to a safe minimum to reduce pressure on the abdominal wall and scar region.  Some women report that pregnancy stretched and smoothed out their scar; other mothers report their scar looked (even more) unsightly and affected the surrounding area; if this remains so after the birth it can be reduced later by plastic surgery.

My scar affected my last pregnancy: should I expect this again?

Every pregnancy is different: there are countless variables.  Despite this, women with adhesion-like pain generally report having increasing discomfort during later pregnancies.

Finally, if you are uncertain about something related to the subject of this post, or are convinced something needs to be checked out, please urge and be prepared to pressure your doctor to work with you.  Read my recent post on getting supportive help in this!

Please remember that this blog is an overview of what information websites and web correspondents have put on the record and that it is not personal or professional advice.

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11 thoughts on “Scars that strangle (4): Pregnancy and adhesions

  1. Tonya Diamond

    I have had extensive abdominal surgeries 3 times and I am now pregnant with my second child. I had my first child pre-surgery and did not experience what I am with this pregnancy. I have had moderate to severe abdominal pain this pregnancy, some days I cannot work because all I can do is lie in bed. I agree that most doctors just dismiss the symptoms. My family physician however, has been more interested and he has diagnosed the problems as related to adhesions from my prior surgeries. He has written pain medication to manage the symptoms and I can say that it has made a huge difference. I am able to function much better. I am glad you are discussing this because there is little information on this, and medical professionals do not seem to want to address it. As a healthcare professional myself, my guess is that because there is little that can be done, doctors do not want to spend much time on it.

    Reply
  2. Fred Vanderbom Post author

    Thank you, Tonya, for your informative and extensive Comment.
    It’s good that your family MD has been willing to engage and that suitable medication has helped you.
    Although I research what I write about as thoroughly as I can and have so far had no critical comments, it is valuable to get personal experience feedback like yours.
    As a pastoral carer, I’ve also worked with the healthcare world for many years and my thinking is also that many doctors don’t involve themselves with conditions outside their immediate area of expertise or for which there may be no straightforward treatment. Many of us wish they would just briefly explain this.
    Best wishes for this pregnancy!

    Reply
  3. Ashley KJ

    I am currently 5 weeks pregnant and believe I have abdominal adhesions again. About 7 months ago my OBGYN performed lysis of the adhesions, and the pain did go away (adhesions running the length of my bowel to appendix and scar tissue bound up my right ovary and fallopian tube and was collecting fluid). About 4 months ago the pain slowly started to come back. I am almost 100 positive that it is adhesions again (pain almost exactly the same and in the same place), although the only medical professionals to concur were my pain management doctor and my acupuncturist. The pain had been under control with Lyrica 2x DAILY and Vicoden at night only, but since I am pregnant, I have had to stop taking both medications. I am back to sharp, stabbing pains (primarily at night when lying down). I know I can take Tylenol, but of course it is of little relief. Any advice in any of this? Very scared, want most of all to take care of the baby.

    Reply
    1. Fred Vanderbom Post author

      After a few days to re-read and reflect on my post, a reply at last. What you write makes me feel for you, as much as I can as “a mere male” who’s spent much of his life caring for others in my family and beyond, and I’m sorry if my tardiness has been hard on you.
      I must also repeat here that I’m not medically trained, just well-read, informed and passionate about this and related subjects.
      It makes me sad to realize that you seem to be in a “perfect storm” in terms of the worst cases I mentioned in this and my previous posts about adhesions. You’re quite likely someone who’s adhesion prone and whose growths may well keep redeveloping. This is a reason why doctors are often so evasive: some medical problems are just hard to resolve. Several old friends and contacts of mine (women) have been through adhesion surgery several times: probably another reason why surgeons are reluctant to engage with you.
      You’re right about putting the baby’s future well-being first, so yes, massage, safe or light medication, acupuncture and alternative therapies if you can access a good therapist – these seem your best course. And try distraction: my DIL finds long hours at work are better for her than most alternatives.
      It looks like being the longest 9/12 of your life. Best wishes.

      Reply
  4. shannon

    This is my third healthy pregnancy. Or so I thought. However, a week ago I was admitted for the same pain. I’ve never been told I have adhesions, however everything I am experiencing matches all the studies I have read. After endless series of tests and all coming back okay, I am so confused. The pain is not in my head. It is a little bothersome for me that all of the Drs, Obs, and surgeons that have seen me dismissed me as being fine. However I know it’s not in my head. I am in such pain that even morphine only helps for about thirty minutes. Is it possible I will have to terminate to eliminate the pain or just be miserable for the next five months?

    Reply
    1. Fred Vanderbom Post author

      This must be so difficult for you, as it’s only after whatever you decide that you’ll know and it means losing the baby or having surgery. I hope not both. You seem to have 2nd and 3rd “medical opinions” already. Might the doctors agree to you having exploratory laparoscopic surgery as a preferred option to termination? My latest post seems to recommend this.as an option.
      My prayers and best wishes are for you. Do let us know how you go.

      Reply
  5. Brooke

    I am a woman who had pyloric stenosis and my surgery scar is morbid. The doctor actually attached my upper abdominal muscles into the skin during stitching or stapling. The scar is now around 6-7 inches long, I am only 4 months pregnant and barely growing and its already beginning to look different. I am not overweight or underweight. As described in the article, my doctor overlooked my concern. What should I do and do I need to be worried?

    Reply
  6. peacebetween

    Not pregnant yet, or married, but this is something I’ve thought about endlessly in recent years (I’m 26 right now). I have a huge scar on my stomach… one going vertically, the other going horizontally… the cross happens kind of around my belly button. Scar runs from below my breastbone down to my lower abdomen. And then the one across horizontally doesn’t go fully across my whole stomach.

    I was a preemie and had a lot of abdominal surgery. As far as I know, I have no adhesions. There may be a bit of scar tissue left over somewhere but I can’t be for certain as to where that is. They saw it once on an MRI. This scar has been left behind from surgery I had when I was a baby. Obviously it’s grown with me as I’ve grown, but I’ve always wondered what will happen when I do get pregnant… how is it going to change, how is it going to hurt or cause problems?

    I’m glad someone’s writing about this now… I’m trying to prepare myself for when I eventually decide to have a baby. I don’t want to put myself in danger, or the baby in danger. I’ve never approached my gynecologist about this or anything… but it’s on my mind 100%. I have this irrational fear that I’ll explode, or the scar will split or something.

    Reply
    1. Fred Vanderbom Post author

      Thank you for your appreciative and informative response to this post. It is so understandable that many women wonder (to say the least) how past abdominal surgery will affect them in later life, and especially during a pregnancy. I understand that to date you have had few if any problems, and this will probably indicate what will happen in the future. We can also be glad that many surgeons take extra care when working on a baby and girls to reduce the possibility of future problems. Best wishes!

      Reply
  7. Steph

    Hi, I have extensive scar tissue on my abdomen from vaser lipo which went wrong. I am now trying for a baby and am worried my stomach will not stretch enough during pregnancy due to the thick layer of scar tissue under my skin. Does anyone have any information on what I can expect as I’m very worried?

    Reply
    1. Fred Vanderbom Post author

      Steph, I very much hope you’ll get some useful feedback to your question posted here.
      However, as my blog gets only some 100 “hits” per day, I encourage you (if needed) to post your question elsewhere also: Patient, Topix and MedHelp are forums that come to mind. The best forum for you at present would be Facebook, if you are a member. Even though as I understand you have not had pyloric stenosis, its “Pyloric Stenosis Support Group” (a closed or members only Fb group) is by far the most trafficked, and quite a number there discuss the effect of scarring on pregnancy – although I recognize that your scarring may well have different effects from a surgery scar, which cause discomfort or pain but don’t greatly affect a pregnancy.
      Best wishes!

      Reply

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