Who knew these were a thing? Not me! Not until last December (2023) when I started bleeding at 5.5weeks pregnant.
I was seen at hospital the following day, they could see the sac but couldn’t confirm if it was a miscarriage on the way out or if it had actually implanted low in my uterus at the site of my C-Section scar. Neither was a positive outcome.
I had to go home and wait a long 6 days, bleeding every time I went to the toilet wondering constantly if I would miscarry naturally. Still going to work and socialising best I could to distract myself from the reality.
As the days passed I hadn’t experienced what I would describe as a major bleed and I started to think it must have implanted low down and was holding on/still growing.
The following week I had another scan and there it was, a little heartbeat, our baby was holding on trying to stick around, however it was during this scan that the consultant confirmed it was in fact a C-Section Ectopic pregnancy.
Although people have gone on to have babies at the end this type of ectopic pregnancy, it is high risk and dangerous for both Mum and Baby often resulting in haemorrhage, pregnancy loss, uterine rupture and even hysterectomy.
At this scan they also noted internal bleeding, my uterus was full of blood so I knew what had to be done. With a little boy at home needing a healthy Mummy and knowing we wanted the chance to try again for baby no2 I had to protect my health and future fertility.
An hour later I was booked in for surgery (D&C Procedure) the following day and was sat in my pre-op appointment. Scared, tearful and anxious.
I emailed work that evening to tell them I would be off and explain what had happened. They were amazing; understanding and compassionate which I was very grateful for.
We made plans for childcare, packed a bag and tried to sleep ahead of a big day back at hospital. I’m not good with needles and given the shit circumstances we found ourselves in it’s safe to say I was nervous.
During this type of situation somehow Ian (my husband) manages to provide the perfect amounts of love, care and even humour (where appropriate). He couldn’t stay with me once I was admitted to the ward as it was women only so he stayed in or near the hospital all day and just knowing he was close by provided comfort. The women I met and chatted to were all lovely, each of us experiencing individual issues of our own yet still supporting each other and giving hope to one another.
I’d never had general anaesthetic before so this was a concern. I was worried my low blood pressure would result in me not waking up (perhaps a little dramatic but true).
I was very well looked after and felt in safe hands all day. When it was time to go to theatre I thought about my late mother in laws phrase “it’s time to get my big girl knickers on” she used to say this when faced with a tough situation so I channelled the motto and took strength from it.
As the anaesthetic was going in it seemed to take ages and I remember saying “why am I not asleep yet” the next thing I know I’m waking up in recovery and it was all done. I came round fine and was allowed home after a couple of hours.
I was then off work to recover and also for Christmas. Lots of distractions and time with Tommy and Ian helped over the following weeks. I also had weekly blood tests following the procedure to monitor the levels of HCG (pregnancy hormone) in my body to make sure they were returning to zero, this was confirmation that the operation had been a success.
The consultant informed me I needed to go back to see her after my first cycle to have a scan before trying to conceive again, this was to check for something called a niche, also known as a scar defect or isthmocele. This part of the story will follow in a separate blog.
I am conscious there may be women reading this who have had previous C-Sections and want to go on to have more babies, my intention is absolutely not to make anyone anxious or worried. Thousands of woman go on to have no complications with future pregnancies. My aim is to raise awareness of this so woman are more able to advocate for themselves should they have any concerns or symptoms. I had no idea a this type of ectopic pregnancy existed until I found myself experiencing it.
It's also worth noting I do not regret having my first child via C-Section delivery. That was the safest way to bring him into the world and if I had the time over I would still make the same decision.
C Section Scar Ectopic Pregnancy (CSEP) – Info
Caesarean scar ectopic is one of the rarest of all ectopic pregnancies
CSEPs occur when a blastocyst implants on a previous Caesarean scar. The scar tissue is not as strong as the uterine wall.
CSEPs carry high risk of uterine rupture and life-threatening bleeding it’s recommended that the pregnancy should be terminated.
There are some cases of woman continuing with the pregnancy and the outcome being successful.
CSEP occurs in approximately 1 in 1,800 to 1 in 2,600 pregnancies.
Often there are no symptoms of CSEP until complications occur – unlike a typical ectopic pregnancy, about a third of CSEP patients will not experience cramping or spotting early in pregnancy.
CSEP is not caused by anything a patient has done. You can’t prevent or reduce the risk.
Many woman who have had previous C-Sections go on to have further pregnancies without this complication
The more C-Section deliveries a woman has had increases the chance of experiencing a CSEP.
The majority of women will go on to have a normal pregnancy following a caesarean scar ectopic pregnancy, with risk of recurrence reported to be 3-5 per 100 women.
With the number of women having caesarean sections increasing, the incidence of caesarean scar ectopic pregnancies is also increasing.
A niche/scar defect/isthmocele develops if the incision from a past c-section doesn't heal completely. A niche can cause infertility or problems with future pregnancies.
The presence of a niche can increase the chances of a CSEP occurring.
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