Tag Archives: pregnancy

Pregnancy post-Pyloric Stenosis

One of the most visited posts on this blogsite deals with how having had infant Pyloric Stenosis (“PS”) affects pregnancy.

This question must be answered by looking at several aspects –

  • Will the scar hold?
  • What do I need to know about adhesions?
  • Could I pass on my PS to my baby?
  • Reliving the past – and the trauma

Will my scar hold?

The short answer is Yes!

Our skin varies, as do our stretch marks, as do our scars.  Your scar may stretch and it may change in appearance, perhaps permanently, perhaps not.  Or it may stay much the same, which will put extra stress on the surrounding skin and underlying tissue of the stretching abdominal wall.  This may create a different pattern of striae (stretch marks caused by the dermis or outer tissue tearing) from the usual.  So there are several unpredictable possibilities, but one thing does not happen: your scar will not rupture.

When a surgical wound is healing it can rupture and need repair. Inadequate repair of the underlying tissue can cause a post-operative hernia which will sometimes heal without further intervention, sometimes not.

C 16w 2010But once scar tissue has matured (losing its redness takes a year or two) it is harder and tougher than normal tissue and far less likely to rupture than the surrounding tissue.  The stretching of pregnancy may cause itching, pain, or a tearing feeling, especially in the scarred area, but this won’t affect your baby, womb, or pregnancy, and your doctor can promise you this!

This is how one mother answered this question –

My niece has similarities to your situation, here is what happened with her.

Nothing bad happened to her baby and he was able to grow just fine – your scars will not affect your bub.

As her baby grew it stretched her scars causing shooting pains, the pains were only every now and then.  They only caused her to worry because she thought it may not be the scars and maybe it was something wrong with her baby.

Her scars are right through stretching right down the middle of her stomach in a T like form: she had an operation when she was born and then again when she was 5 and her scars are attached to her muscles.  Her stomach also didn’t grow very big compared to most pregnancies, so if your belly gets bigger than hers it may cause a bit more pain than ‘every now and then’ (but that’s just a guess based on no medical knowledge).

Hope this sets your mind at ease, both you and your baby will be fine. (– anon)

What do I need to know about adhesions?

All abdominal surgery triggers the growth of adhesions, a web like formation of tough scar tissue that develops between areas that have been exposed, cut or otherwise affected by the operation.  The organs inside our abdomen don’t like the fresh air and drying that occur during open surgery, nor the gas that’s used to inflate the abdomen for keyhole surgery.

A laparoscopic image of adhesions between the right diaphragm and liver

Everybody develops adhesions after surgery: these link different abdominal organs (e.g. the stomach and gall bladder or liver) or they link one or more of these with the inside of the abdominal wall.  This is noticed in only a minority of cases, but when adhesions make their presence known it can be very troublesome, causing pain and snaring, choking or otherwise disrupting the normal working of our abdominal organs in the affected area.  Adhesions are hard to treat, as surgery to remove them in affected people will inevitably trigger the growth of more of these nasty webs. I have written about adhesions several times – use the Categories or Tags search boxes to find them or go to Dr Google!

Pregnancy may make a woman with PS in her history aware of adhesions that had not troubled her before. She may feel pain or tearing in the region of her scar as her body changes; although this is uncomfortable it is a normal process and not hazardous, and will probably be a temporary although added discomfort of pregnancy.

Because each pregnancy has its own unique character in lots of ways, the pain and tearing sensations of adhesions can come with any but not usually all of her pregnancies.

The best advice for dealing with adhesion and scar pain and itching is what is usually recommended for pregnancy anyway: lots of lotion and lots of massage – which will help some and not others. The end result of the 9 months will we trust be well worth the discomfort and pain.

This is how one mother answered this question –

I am a 36 year old female, with 3 children.  I had my pyloric stenosis operation in 1974, at 6 weeks old.  My scar is now about 5 inches long, a cm wide and has 4 ‘stitch’ marks down either side.  It sits off centre to my right side, vertically.  And without a doubt it is attached to my abdomen at the bottom of the scar!  My mum said it was just about two inches long when first done.

Throughout childhood I complained that my ‘scar’ hurt and this was dismissed by the GP as part of growing!  At 18 I had my first pregnancy, and had a dip in my stomach as it swelled, with a feeling I can only compare to being jabbed with a pin.  It wasn’t so bad with my second child a year later, although the dip was there as stomach grew.  I had my third and last pregnancy at 33 years old, and my last baby was bigger than first two.

I collapsed with severe pain in my middle of right side 2½ years ago, and initially was diagnosed with kidney stones, but the urologist did not think the stones were big enough to cause the pain I was in.  (They were smaller than grain of rice.)  I am now awaiting an endoscopy with a gastroenterologist to see if I may have adhesions.

My scar is definitely pulling upwards towards my right ribs and I am rather unhappy that I have had to suffer for this long to get any answers!  I have been back and forwards between the specialists 4 times now as neither would pin-point pain, but if I were able to ‘operate’ on myself, I am convinced I could put my finger exactly where my pain is!  The pain is at best mild, but can get worse, usually 30-45 mins after eating.  It is constant, but I have learnt to recognise, offset and control it with painkillers.

I have been lucky that none of my children inherited the pyloric stenosis.  I am convinced that my life time of constant stomach problems, cramps, constipation, stabbing pains, nausea, etc etc has been a result of this condition, and wouldn’t wish it on anyone!  Good luck to you all on getting it sorted, and insist on help if your child continues to suffer. (– Kaz)

Could I pass on my PS to my baby?

This is indeed quite possible, and because of the quirkiness of genetics a mother who has a PS history is more likely to have a Py-baby than a father.  It is well-known that 4-5 boys have PS to every girl with it, but part of this means that those girls who do have it carry stronger PS-carrying genes.  Not nice…

The risk is unpredictable, as infant PS is “multi-factorial” and can be caused by non-genetic factors – labelled “environmental” in the medical world, although PS is never caused by what most of us think of as “the environment”!  A woman who belongs to a family tree with another (possible) case of PS is at higher risk than one with “one-of” PS.  So the likelihood of a PS mother having a PS baby varies from almost nil to about 20% according to the several studies that are freely available online, and some few mothers have reported passing on their PS to most or all of their offspring – up to 4 children in a few cases I have on file!

The key thing to remember is: everyone (mother or father) who has had PS can and should be better prepared to give prompt and the best possible care for their new-born Py-baby!

This is how one website answered this question –

  • Pyloric stenosis is the most common infant surgery in the United States after circumcision.
  • Pyloric stenosis reports in the United States have shown as few as 1 case per 3,000-4,000 live births to as many as 8.2-12 cases per 1,000 live births.
  • In general, pyloric stenosis affects approximately three out of every 1,000 infants.
  • If a child with pyloric stenosis is female:
    the likelihood of having a future son with pyloric stenosis is one in five.
    the likelihood of having a future daughter with pyloric stenosis is one in 14.
  • If a child with pyloric stenosis is male:
    the likelihood of having a future son with pyloric stenosis is one in 20.
    the likelihood of having a future daughter with pyloric stenosis is one in 40-50.

Reliving the past – and the guilt and the trauma

Sadly you won’t find this information on the PS-pages of our hospitals’ and paediatricians’ websites …

But having followed what not a few new parents have reported on internet social forums such as BabyCenter, Facebook, MedHelp, Patient, and Reddit, it is abundantly clear that some who have PS in their story struggle with guilt and PTSD, although thankfully not in a life-threatening form.  How many and how severely people are affected in this way is impossible to estimate, as this matter has not been given any academic or statistical study that I have seen.

The now adult Py-baby may find during pregnancy that they (father as well as mother) are painfully reliving their own past, fearful of passing their PS on to their new baby.  It is now known that the fears and deep emotions that many parents of a PS baby experience and convey to their growing child in story and emotionally can affect the in many ways exciting months leading up to the birth of a new person.  In times past, the traumatised parents would keep their story to themselves, which will often affect their child even more.  Sensitive and wise openness is far preferable to the old-time “stiff upper lip”.

Several things will help –

While most couples awaiting parenthood have never heard of PS, those who “own” their PS story will be far, far, far better prepared.  All infant surgery runs a high risk of a chain of unhappy events, including:

  • the horror of an eagerly awaited newborn infant vomiting itself to death;
  • insensitive, even haughty doctors who dismiss the fears and homework of new parents and draw out diagnosing their infant’s problem;
  • the hazards of anesthesia and surgery, increased in the very young;
  • post-operative complications and frustrations;
  • worries about long-term effects, usually brushed off by doctors but well-founded despite this.

Having recognised and to some extent worked through most of the fears and uncertainties is a great bonus.

Parents with a PS history also need to face the possibility of misgivings and guilt feelings that won’t be justified and will be unproductive, but may be very real and therefore also need to be processed.

As well as the above reasons, PS survivor parents preparing for the birth of a baby may be stressed by the possibility of bringing another “imperfect and damaged person” into the world, and by memories of the utter powerlessness inevitably associated with submitting one’s long-awaited newborn to a medical team and their procedures.

But PS parents will also know better than other parents that despite the above, PS is recognised throughout the medical world as the least un-desirable of all the conditions of infancy that usually require surgery.  The surgery by today’s standards in minor and routine, and almost always quickly effective. Any immediate after-effects will usually clear up within weeks or months, and any long-term after-effects (although usually not acknowledged) are manageable and never life-threatening.

The bottom line: I survived, and my baby will too!

Here follow four people’s observations on this subject area –

I am not so much nervous about labor as I am about being the best mother I can be and being the mother she needs.  I have a lot going through my mind right now.  My main concern is how horrible I will feel if she inherits pyloric stenosis from me.  Because of it I had to have surgery at 3 weeks old, it caused me to be so weak from not enough nutrients that I no longer had the energy to cry.  I am terrified of having to go through what my mom went through.  I keep trying to tell myself that she will be fine and everything will work out, but I am still scared... (– Jessica)

I used to work on a children’s gastrointestinal ward in London and would often see this. It’s a small op as far as an adult is concerned, but for any mum and little quite major. Make sure any questions you have going round in your head now, you write down. Make sure you ask all you want to ask, don’t be afraid as no question is silly, and they would rather explain to you what’s happening than have you confused and worried. (– Rachel)

I almost died before I was even born.  After my mother’s water broke and she was in labor for several hours, I had a bowel movement inside the womb – gross! – and the doctor said that was sign that I was in distress and not getting any oxygen so he performed an emergency C-section.

Then after I was fed for the first time I vomited it right back up.  And I kept vomiting after every feeding. I was diagnosed with pyloric stenosis… So I had to have surgery when I was just a few days old.

So my parents almost lost me twice before I was even a week old, and it’s easy for me to see why they – my mother especially – became overprotective parents.  And they passed that overprotectiveness on to me.  Even though I don’t have or want kids of my own, whenever I’m around kids I’m hyperaware of what’s going on around them.

I grew up knowing about all of the horrible things that can happen to children – rape, kidnapping, murder, etc. And it wasn’t just “stranger danger either. ( – Holly)

I had the surgery as an infant and asked in my first pregnancy if my baby could have the same problem.  I was basically laughed at so I never thought of it again.  I was definitely agitated over that because I would have always watched out for it.  It was hard just thinking about my baby having an IV/surgery and I really broke down when we got to the children’s part of the hospital and I saw the crib/bed.  After that though I was fine.  My DH and I held him for 2 days straight – we took shifts at night.  The hospital was so thorough and made us feel like Jacob was in great hands. (– anon)

Recommended: my previous post on this subject –  https://whatwewishwedknown.wordpress.com/2017/05/15/an-abdominal-scar-and-pregnancy/

 

A belly scar and pregnancy

Early 2013 I posted my previous report on this subject area: the last of four posts on how an abdominal surgery, its scar and likely adhesions can be expected to affect a woman’s pregnancy.  This 4th post gave readers links to the earlier posts (which are also well read) and #4 quickly became one of the most read posts on this blogsite!

As I wrote then, I feel some hesitation writing about this subject and including a few of the stories and images posted on the web by brave mothers.  My feelings are surely understandable: male, not a doctor.

Yet my reading and the weight of interest confirm my original decision: women who have had abdominal surgery, whether in infancy (like mine for pyloric stenosis) or in adulthood, have reason to be very interested indeed in how that surgery might affect a pregnancy.  This is even more so if that surgery has already given them grief in addition to their scar: usually gastric issues or discomfort from adhesions resulting from their operation.  On the web there seems to be nothing else than pregnancy forum discussions of this subject, and we’re often told that this subject area tends to be brushed aside by medical workers, perhaps because of lack of knowledge of it.

The fact that so many mothers have written about this on forum sites, some even adding a photo, reflects the fact that people who have been through abdominal surgery, possibly its ongoing effects, and then a pregnancy, know how valuable and reassuring it can be to learn how others have found and managed the one-way journey they are on (or are considering).

Interested readers are encouraged to use the above link and the links in that post to access the personal stories, experiences and images I have posted there.  What I want to do here is simply to add some more “stories” and images.

First, some facts and reassurance

  • Every scar is different, as is every pregnancy: expect each pregnancy (your own and others’) to be different in lots of ways.
  • Every pregnancy involves the miracle of bringing a new life to birth, which comes with considerable physical growth and strain.  Because a scar doesn’t have the same flexibility as the damaged tissue it has replaced, expect some discomfort, perhaps pain – and sometimes nothing.
  • Because scar tissue is stronger than the skin tissue we’re born in, it won’t “give” much: the normal abdominal skin will do all the stretching and often develop striae or stretchmarks.
  • In my many years I have never heard or read of an abdominal scar causing serious trouble.

What some mothers have written –

I am a 36 year old female, with 3 children.  I had a pyloric stenosis operation in 1974, at 6 weeks old.  My scar is now about 5 inches long, a cm wide and has 4 ‘stitch’ marks down either side.  It sits off centre to my right side, vertically.  And without a doubt is attached to my abdomen at the bottom of the scar!  My mum said it was just about two inches long when first done.

Throughout childhood I complained that my ‘scar’ hurt which was dismissed by the GP as part of growing!  At 18 I had my first pregnancy, and had a dip in my stomach as it swelled, with a feeling I can only compare to being jabbed with a pin.  It wasn’t so bad with my second child a year later, although the dip was there as my stomach grew.

I had my third and last pregnancy at 33 years old, and my last baby was bigger than the first two.

I collapsed with severe pain in the middle of right my side 2½ years ago, and initially was diagnosed with kidney stones, but the urologist did not think the stones were big enough to cause pain I was in.  (They were smaller than grains of rice.)  I am now awaiting an endoscopy with a gastroentorologist to see if I may have adhesions.

My scar is definitely pulling upwards towards my right ribs and I am rather unhappy that I have had to suffer for this long to get any answers!  I have been back and forwards between the specialists 4 times now as neither would pinpoint pain, but if I were able to ‘operate’ on myself, I am convinced I could put my finger exactly where my pain is!  The pain is at best mild, but can get worse, usually 30-45 mins after eating.  It is constant, but I have learnt to recognise it and control it with painkillers.

I have been lucky that none of my children inherited the pyloric stenosis.  I am convinced that my life time of constant stomach problems, cramps, constipation, stabbing pains, nausea, etc etc!! has been a result of this condition, and wouldn’t wish it on anyone!

Good luck to you all on getting it sorted, and insist on help if your child continues to suffer.

K 2010

I also had Pyloric Stenosis as a baby and it was corrected.  I am now 7 months pregnant with my 1st baby (a boy) and had only noticed occasional stretching pains in my scar.  Doc said it wouldn’t be affected because it had been so long since surgery but I still occasionally feel stretching pains.

T G 2012

My scar gives me problems all the time and until today, I thought I was the only one….  Seeing all this has really helped me out personally!  Pregnancy is a little tough on my scar: the pulling sensation and sharp pains suck to say the least but the little angel in the end makes it all just disappear!

Does anyone have any remedies I could try to help ease the pain?  I’m 27 weeks pregnant today and the pain seems to be a little worse every day and I’m wondering what I can do to be as comfortable as possible.  My scar just feels like it’s going to burst open…. The pulling, burning and stabbing pains are becoming unbearable and any advice is much appreciated!

J D 2011

I had my surgery when I was 4 weeks old.  I am now 26 with 2 kids.  My first was born in 2003 and the second was born in 2007.  I never had any serious issues with my scar.  I did have some pulling of the scar tissue from my expanding belly when I was pregnant with both of my children but it was never painful in any way, it was just a tight pressure feeling.

None of my OBs were ever worried about my scar.

L T 2010

I am 32 weeks now and it has gotten so much worse like stabbing and tearing… I asked the nurses at the hospital and the doc and no one seems to know anything at all… it’s so frustrating.

D C 2010

I too have a large scar on my belly.  I had a pyloric stenosis… I was also worried that it would tear or something.  It was painful during my first pregnancy and itched a lot.  I rubbed a lot of scar cream into the area.  This pregnancy I’ve had no trouble at all.

S 2010

I have a vertical scar on my belly.  It’s not really a very nice scar.  During my pregnancy the scar became much wider and it seemed to sit on top of my skin instead of in it.  I was worried about whether it would ever get back to looking a bit normal again.

I’m glad that after my pregnancy it did get back to what it looked like before and it did not stay all that wide.

So you don’t need to worry.

S 2012

A picture is worth 1,000 words…

As I did when I posted the photos I chose for the earlier posts, I want to say “thank you” to the women who have posted an image of their belly scar taken during their pregnancy.  I have posted these images in support of their original purpose, protected the anonymity of these people, and will withdraw any image on their request.

In these photos notice just two further things –

  • each scar looks very much “together”, and
  • one of the transverse (horizontal) scars seems to have moved to the side.

DS 2011

RJ 2009DJ 2011SP 2009C 16w 2010

Adhesions and pregnancy

Like many who had surgery as a baby, I’ve been left with a few issues as a result.  Abdominal surgery at any age often leaves a bit of collateral damage, and when the surgery happens in infancy, this damage can grow with us.  The harm may be physical, cosmetic, or even emotional.

When I was just 10 days old I had surgery, caused by a stomach blockage, pyloric stenosis.  Discovering that I am not unique in having some “issues” as a result of this, and being in a position to do something about it, I started blogging here just over three years ago.

Adhesions 01One of the most common problems after abdominal surgery is the growth of adhesions, web-like inelastic scar tissue that can develop wherever the surgery went.  Adhesions may connect the abdominal wall to abdominal organs, link one abdominal organ to another, and sometimes obstruct them from working as they should.

Many of us have adhesions without being aware of them.  Virtually everyone who has had abdominal surgery will have adhesions, although in the great majority of people these will also remain unnoticed.  But a minority of former patients will be troubled by adhesions, some to the extent of choosing to have further surgery to get relief, all-too-often only temporary.

Such adhesions will be a special worry for those women who wonder how their already annoying or uncomfortable adhesions will behave when they are carrying a baby.

Will the abdominal surgery I had stop me from having a baby?

Most unlikely if the surgery had something to do with the gastric or food passage.  The scar and/or the adhesions may cause extra grief during a pregnancy, but they won’t stop it or damage the baby.

Will the surgery I had affect my pregnancy?

There is a small chance that adhesions will add to the discomfort and pain that are an expected part of most pregnancies.

The good news:
Good news bad news11)  From the published material it seems that only a small minority find that their surgical scar and/or the adhesions under it become more of an issue during their pregnancy, and those who do have found (as is usual) that every pregnancy is different also in this way.
2)  Although there may be unpleasant but understandable itching, stretching and tearing pain at or under the surgical scar, and some have reported a little bleeding, nothing more serious has been reported.  A mature scar is stronger than the surrounding abdominal wall and won’t tear open.  The stretching and bleeding will heal.
The bad news:
1)  If any of this happens to you it is hardly pleasant and it’s an unwelcome extra challenge during the long months of waiting and wondering.
2)  Count yourself privileged if you have a doctor or obstetrician who pays attention to this aspect of your pregnancy.  Because there is no easy “fix” for adhesion pain most medical people won’t want to hear or say much about it.  Be prepared for a brush-off.  Be content with some pain relief.

What can I do to reduce the discomfort caused by my earlier surgery?

As mentioned, most doctors believe it’s best accepted.  Creams and massaging are worth a try.  There are more costly and specialised therapies advertised online which some have found very good but others not.

Considering mild pain relief as recommended by your doctor, exercising and keeping weight gain to a safe minimum are sensible options.

 *         *        *

Two and a half years ago I wrote a more detailed post about this subject with some fear and trepidation for reasons that will be quite understandable.  How many males untrained in medical science would take it upon themselves to write a post on the effect of abdominal adhesions on a pregnancy?

boy writing1Yet this 2011 post has become by far the most read one of the 160 I have written about some of the issues that can arise from infant surgery later in life.  WordPress, the host of my blog, has encouraged me to revisit the subjects of my most read posts, so with a new year, I offer the above points as a summary and a lead-in.  I have not repeated most of what I wrote in the 2011 post on adhesions and pregnancy.

The 2011 post was the 4th of a series dealing with the problems adhesions can sometimes cause after abdominal surgery.  If this is an “issue” for you (the reader), I suggest you follow the link (click on the highlighted words) above and read all 4 posts and other readers’ valuable first-hand Comments on their subjects.  The “Categories” and “Tags” boxes on the right of this page will help you locate other posts that may be of help.

Communication04Many have found this blogsite to be a good place for getting information about a list of possible issues around infant surgery – especially the treatment and possible effects of infant pyloric stenosis, the most common reason for life-saving infant surgery.

You won’t get personal professional advice about your particular medical problem here, of course.  But this blog wants to continue to give well-informed, responsible, and practical facts and experience-based advice about infant surgery and its possible effects.  I have brought this together from the writing and reports of thousands of not only medical professionals, but also from parents and the survivors of infant surgery who have posted their experiences and stories on the web.

2013’s most visited infant surgery (SIS) posts

This last post for 2013 on the “Surviving Infant Surgery” (SIS) site was written away from home and after a very busy but delightful, Christian, and family Christmas.  I thought if might be of interest to list the most visited posts of this blogsite during the past year.

It is with continual surprise and gratitude that after three years I continue to see the interest in the SIS blog rise each year, so that the total “hits” now number almost 50,000.  Even more gratifying is the feedback from many readers, online and by email.  The message of your comments is, “Thank you, you’re helping people like me (or us) so much with your honesty, careful writing, shared experiences, and by helping me / us to realize that my / our experience is far from a lone or odd one.  Do keep up the good work.”

The post that drew the most interest by quite a margin was about the possible long-term effects of infant pyloric stenosis (“PS”) and the surgery that often follows it, Ramstedt’s pyloromyotomy.

ponderAdhesions after a pyloromyotomy were a frequent and often troublesome concern among those who used this blog during 2013.  Two of the top 10 discussed this, the posts # 2 and # 6.  The 2nd most visited post dealt with the effect of the surgical scar and internal adhesions on a pregnancy, and the subject of #6 was the adhesions that can be expected after any abdominal surgery – with special reference to the trouble adhesions have been found to cause to people after an infant pyloromyotomy.  Sadly, this is one of the subjects raised by PS and its surgical “remedy” that most doctors brush off with a vengeance: there is no prescription, no surgery, and no other easy way of dealing with abdominal adhesions.

The subject that had the next (3rd) most readers’ interest was related to this also: Does an abdominal scar cause trouble during pregnancy?  The short answer is that it can – but usually if any, it is a relatively minor discomfort.

The post with the 4th highest number of “hits” discussed a deep fear and occasional reality: Can PS raise its horrible head again after a pyloromyotomy?   Continued vomiting, although of a less violent form, is quite common, even to be expected, after a pyloromyotomy, although usually only for a short time.  It is very understandable that parents who have just been through the harrowing experience (indeed, traumatic for many) of infant PS will be more than anxious about this possibility.  While most doctors and hospital staff are reported to be very supportive in this situation, many parents are unsettled (to say the least) by the earlier bland and simplistic assurances that “surgery fixes PS immediately, permanently, and without any after-effects”.

Self-exam1The post that came 5th in popularity in 2013 reflects another area of anxiety and emotional pain that has come with the surgery for PS: while some care nothing about their scar, others can tell tall stories about it, and some hardly think about it, there are many “py babies” who grow up to hate their scar with deeply felt hatred and embarrassment and would dearly love to be rid of it.  So one of my posts on scar reduction plastic surgery rated #5 in interest.

Symptoms of post-traumatic stress sometimes result from the anxiety, surgery, and maternal separation that PS can bring, especially from the way the condition and its surgery were handled up to the late 20th century.  This subject was also discussed in many posts, but the one that rated # 8 in 2013 made the top 10.

By using the “Categories” search box (top right of the page) or searching for keywords or “tags”, readers will usually be able to find a number of posts on each of these and other subjects.

The “My Story” page (with its tab at the head of every page) has also rated very well.  Thank you for your interest, encouragement and support!

At the end of another productive year of SIS, I want to thank all my readers and especially those who have given feedback online or by email.

An abdominal scar and pregnancy

How the scars from abdominal surgery will affect women in pregnancy has been outlined in three posts on this blogsite, and all may be accessed via the “Categories” box on the right of this page.

The first post on the effect of an abdominal surgical scar on pregnancy was added here in 2011 when I dealt with adhesions, inflexible strands of scar tissue forming a web between the scar and abdominal tissue, muscle and organs.  Adhesions are most common cause of extra itching and pain during pregnancy, and sometimes even some bleeding.  They can also cause trouble apart from the rigours of pregnancy.

The second post outlined what can be expected and the overview was generally reassuring: surgery scars will quite likely make your pregnancy more eventful in any of several ways, but are very unlikely to be a major problem.

This post was followed a week later by a third one.  My wife of over 40 years and I have parented four  wonderful children, all of them happily married and with their own kids, I have also worked with people of all ages and many situations of life in a church context, and have read widely for 15 years before blogging on the subjects of this site.  Nevertheless, I am a male, and not a family doctor, so that writing about an aspect of pregnancy prompted me to decide it was important to let a careful sample of women “speak” about how their abdominal surgery affected their carrying a baby and giving birth.

One of the things missing from these three posts is what I have done in my previous two blogs.  Here I want to pass on another selection of photos:  images which mothers have posted on their blogsite or a pregnancy forum to reassure interested readers about how their growing belly and scar may be affected.  Most have been able to post their story in a relaxed way, some even with pride or in fun, and perhaps others with some misgivings.  I and I trust many others will be grateful to them all – sharing usually reduces our fears.

The Shape of a Mother is a great blog for you if you are interested or concerned about this issue.  One of the posts there comes from Fiona, who tells readers about her harrowing emergency appendectomy during her first pregnancy; her scar was stretched and keloided somewhat (which it might have done anyway) but thankfully it didn’t rupture or cause major after-griefs.  And here is a link to Fiona’s update.  Audrey’s story and photos (one which is included below) may also be worth reading in full.

What I have written before will become even clearer with these photos, namely that –

  • abdominal scars take on a life of their own as a surgical wound heals;
  • they will be affected by pregnancy but being made of tough, even hard scar tissue they will often stretch less than the surrounding skin and muscle layers;
  • some will do something like shatter, breaking up to some extent; and
  • none show obvious signs of trouble.

I trust that these images and the information and experiences given in earlier posts will clarify and reassure.  Heartfelt thanks are due to the 10 women who have allowed their images to be posted – I am sure to reassure others.  To these women I say:  Thank you!  And if you would like my caption to be altered or your photo withdrawn, please contact me (via the About tab).

Click on an image if you want to enlarge it.

And please consider sharing your own story as a Comment – or send me an email to have it posted.

RUQ PS and glbldr scars

This woman had PS surgery as a baby, and a gallbladder removal as well as several children in her adult years.

Upr transv PS 36w

This transverse pyloromyotomy scar looks good at 36 weeks

Upr transv PS scar 37 wks

Another transverse scar after PS surgery – at 37 weeks and even tidier

Transv scar2

This scar may be relatively new or may have reddened from stretching, but it’s fine

Transv scar1

Pregnancy does not seem to have affected these vertical and transverse scars from more complex surgery

Lwr midline scar

A lower midline scar and one from appendix surgery – the first is very indented but pregnancy does not seem to have widened it

Upr midline inf surg

Unspecified infant surgery and a Cesarian birth left these incision and feeding tube scars – large but not due to pregnancy

Upr midline PS scar

This midline scar from PS surgery has remained tidy

Para-midline PS scar

A para-midline PS scar, looking fine and unchanged by pregnancy

Para-midline PS 28 wks

Finally, another para-midline PS scar, sunken and less tidy but also not obviously affected by pregnancy

Infant surgery and pregnancy – at first hand

In my previous post I summed up and answered the main concerns of those women who have had abdominal surgery in infancy or childhood and wonder how this will affect having a baby.

In this post I want to pass on some of the variety of actual experiences such people have actually had.

Many report a trouble free pregnancy

Hi.  Just wanted to let you know that I am 29.  I had PS as an infant and have a 4 in scar across the right side of my upper abdomen.  I just had a baby 5 months ago and gained 60 lbs with the pregnancy.  My stomach was stretched to the max and my scar is fine.  No problems but it did look a little funny when I was pregnant.  It looked higher up and longer then but now it is back to normal.  Good luck with starting a family.

K S – 2010

I have a huge abdominal scar from when I had surgery as a baby to correct an intestinal problem.  It is all the way across my stomach right above my belly button.  I had absolutely no complications at all during my pregnancy.  It is actually flatter now than it was before.  I asked the doctors tons of times whether it was going to pose a problem or not and they assured me it would be fine.

K. – 2009

I had ps and got a huge scar about 5 inches long.  I have 3 kids too.  I had my first daughter at 16 yrs old and no problems with the scar.  The second at 20 and I was huge but no problems with the scar… my son had ps.  The 3rd a girl at 25 and kinda huge and still no problem, but had a bad gall bladder and had surgery 6 days postpartum.  Not one dr was worried about my scar.  They did however think Ihad my gall bladder out until I told them it was ps.

B S – 2010

hi, I had pyloric stenosis when I was a baby and have a scar down my stomach.  I have two children, one who is now nineteen and had no problems during either of my pregnancies.  I have never had any pain or swelling with my scar.

J P – 2010

Yes, I have a scar from surgery from a car accident, removed spleen, appendix, gallbladder, and some intestine.  it goes from my lower chest to the bottom.  I had this when I was 16, I am 28 now and 2 children, and it is just a little wider than when I had surgery but it didn’t hurt or anything.  Mine did not go back, it stayed a little wide, but I scar really bad and have deep ugly stretch marks.  You look like you healed pretty good, so it might not be as bad as mine… guess it just depends on the person.

B. – 2009

Others reported itching and pain but never any danger for the baby

A ftm here at 32 weeks… I have a scar on the upper right hand side of my abdomen right over my ribs from a surgery when I was born (I had pyloric stenosis for anyone familiar); my incision was improperly done and healed funny with lots of scar tissue build up.  Now that my belly is getting bigger I am in so much pain!  It feels like my scar tissue is ripping and it is impossible to get comfy in bed or wear a bra now.  Any advice for relief?  Is this ok or could this be damaging?

The only response was a rub with oil.

J D – 2011

The only problem I’m having is with my scar across the upper right part of my abdomen.  I had pyloric stenosis when I was born and had surgery at just a few days old. … The scar tissue is not letting my skin stretch like the rest of my stomach, so it is pretty painful.  It hurts when touched and is swollen above the scar.  It hurts when I twist or sit up sometimes.  It is not causing any harm to the baby, it is just painful for me.  I will live though!  🙂 I am just happy it isn’t harmful to the baby!!!  All-in-all I am feeling very blessed to have had such an easy pregnancy so far.

E B – 2012

I had abdominal surgery when I was 2 months old and it did hurt a bit during pregnancy but nothing major.  The scar also got smaller/less visible and actually rubbed off in some places during the end of my pregnancy.

H B – 2009

I am 27 weeks pregnant and I have the same pain.  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.

I told my OB about it but she didn’t really seem to know anything nor did she seem to care to find out.  It just feels like something is not normal … – I wonder if the surgical practices 20 some years ago were outdated and now I’m feeling the effects of it?

D G – 2008

Also, my scar gives me problems all the time and until today, thought I was the only one…  Seeing all this [on the web] has really helped me out personally!  Pregnancy is a little tough on my scar – the pulling sensation and sharp pains suck to say the least but the little angel in the end makes it all just disappear!

And she added a week later –

Does anyone have any remedies i could try to help ease the pain?  I’m 27 weeks pregnant today and the pain seems to be a little worse every day and I’m wondering what I can do to be as comfortable as possible.  My scar just feels like it’s going to burst open…. The pulling, burning and stabbing pains are becoming unbearable and any advice is much appreciated!

M B – 2011

 

And some are worried most by the possibility they will pass their condition on

I am not so much nervous about labor as I am about being the best mother I can be and being the mother she needs.  I have a lot going through my mind right now.  My main concern is how horrible I will feel if she inherits pyloric stenosis from me.  Because of it I had to have surgery at 3 weeks old, it caused me to be so weak from not enough nutrients that I no longer had the energy to cry.  I am terrified of having to go through what my mom went through.  I keep trying to tell myself that she will be fine and everything will work out, but I am still scared…

J G – 2011

If you have had abdominal surgery and a pregnancy, you may have something helpful to add to these experiences.  Please share something of your story here or on one of the web forums: Facebook, Medhelp and Topix seem to be among the most used and read.

Pregnancy after having had infant surgery

In 1½ years of posting weekly about the effects of infant surgery, the blogs that attracted the greatest number of “visits” were about related subjects: adhesions from the surgery (highest) and adhesions and pregnancy (3rd).  Both are clearly “hot” topics.

Almost a year ago I wrote quite extensively about the possible effects of infant surgery on baby girls if they have a baby in later life.  Unsurprisingly, the strong interest in this subject was not reflected in the number of Comments on the post.  Your blogger here is not female nor a medical worker, making that understandable.  However, let me explain to the reader that my interest in blogging on infant surgery is purely and simply (a) to explore and document my own PTSD struggles resulting from my infant surgery for pyloric stenosis, and (b) to pass on to the blogosphere’s interested human population some of the many things I have learnt and benefited from my years of privately researching the human issues around infant surgery.

Here and now I want to give just a quick overview of what those women who have had infant surgery to their abdomen might expect during a pregnancy.  For more detail, click on the above link to my June 2011 post on this subject, or google for more information.

In summary, if you have had infant surgery on your abdomen and wonder whether and how this may affect your pregnancy, there is – (1) most likely, good news, (2) the possibility of some trouble ahead, and (3) good news even if you have some problems.

1                    It’s most likely that your infant surgery will have little effect on your pregnancy.

Judging by what people have posted on the internet, about 50% tell us they had no problems whatsoever from their scar or from adhesions under it.  It’s more than likely that those who have an uncomfortable time will go to the effort of writing about it, so we may conclude that the great majority regard it as “not an issue”.

It would be wonderful to have more than anecdotal evidence for this conclusion, but for what it’s worth, in 15 years of internet research, I have never come across a medical study on this.

I’d like to think that if considerable numbers of infant surgery patients went on to have difficulties carrying a baby, the medical world would recognise this and direct more research to improving its management.

A surgical scar takes up to three years for mature, but in that time becomes tougher and stronger than normal tissue, although also far less elastic.

2                    Some abdominal scars will cause pain or discomfort, especially during pregnancy.

This may range from itching and stabs of pain to feelings of internal pain, tearing and even some bleeding.  This may occur during any but the first months of the pregnancy.

Rubbing a soothing cream over the uncomfortable area always feels good, and massaging an old scar and adhesions under strain is helpful.  However, many of the often recommended creams (e.g. cocoa butter) are useless except as a lubricant, and some (such as Vitamin E cream) may be worse as they can cause a rash on stressed skin – as even I as a mere male have found – lol.

It should be realised that not only the scar we see is tough and inelastic: a surgical scar goes deeper than the incision that it repaired.  Almost all abdominal surgical scars come with adhesions, scar-like tissue that develops web-like between abdominal organs in the body’s attempt to heal collateral damage done by the surgery and even by the gases and air to which the wound was exposed.

Often these adhesions can be felt by the patient in later years but most cause little or no trouble.  However, like the outside skin of the abdomen they may object to the growing baby.

3                    Whether a mother-to-be has discomfort or not, it is virtually impossible that her scar will cause major difficulties.

The internet record shows that many women who have had infant abdominal surgery understandably wonder and worry about how their first pregnancy will be affected by their external and internal scarring.

It is very significant that on the web there is simply no mention of anybody having their scar rupture or herniate due to pregnancy, although this is possible.

Several women mention the scar of their incision line widening a bit, others found theirs became less indented, sharp and obvious, and others again have reported their pregnancy “exploded” their scar along with their abdominal skin, so that it became more like their striae or stretch marks.

Others have mentioned that during their pregnancy their scar and the indentation that often comes with belly scars almost disappeared as their abdomen was stretched.  But only then…

To those who have had abdominal surgery and then a pregnancy, I ask, Would you be game to tell us something of your experience here?  Either as a Comment, or you’re most welcome to email something to me that I can post here. If you’re really game, include a photo to post .

First-hand comments on posts such as this one will be highly appreciated by many of our readers, but may once again be elusive.  So a good selection of quotes from web forums may have to do.

In any case, in my next post I plan to pass on some of the comments women have posted elsewhere about this subject.