Pregnancy After Hysterectomy

Pregnancy is a beautiful phase for every woman, but if it is faced with complications that can be life-threatening it can become the most difficult phase in that woman’s life emotionally and physically. When it comes to complications, it is very difficult if it is a rare complication, and becoming pregnant after a hysterectomy surgery is indeed rare and hence difficult for the mother as well as the doctor. Therefore, if you suspect you may be pregnant even after a hysterectomy surgery then it is imperative that you understand its symptoms, treatments required and basically how to deal with it.

Hysterectomy- An overview

Hysterectomy is a procedure where a woman’s womb or the uterus is surgically removed due to various health reasons. The uterus is the primary organ in a woman’s body where a fetus is grown to a full term in pregnancy until delivery. This surgical procedure may involve partial or complete removal of the uterus and organs such as fallopian tubes and ovaries as per the medical need. Once this procedure is performed, a woman will not be able to menstruate and hence pregnancy will be not possible. This procedure is irreversible and permanent.

Hysterectomy- Why is it needed?

A hysterectomy procedure is required if there is a serious condition that is affecting your reproductive organs. Some of the conditions are:

  • Uterine Fibroids: Non-cancerous growth that appears on the uterine wall which causes intense bleeding and pain during the menstruation.
  • Intense Bleeding: Abnormal heavy bleeding and unbearable abdominal pain which flags a serious underlying health issue.
  • Uterine Prolapse: This is a condition in which the uterus slides from its normal place towards the vagina. Numerous vaginal birth, obesity, menopause, etc. can trigger uterine prolapse.
  • Adenomyosis: A condition in which the tissues that meant to grow on the exterior of the uterine wall starts to grow in the interior wall.
  • Endometriosis: This is just opposite of the above-described condition. Here, the tissues that line the interior wall of the uterus start to grow on the exterior wall and above the ovaries.
  • Uterine Cancer: Advanced stage of a cancerous growth in the uterus, ovaries, cervix or the endometrial wall will necessitate a hysterectomy.

Hysterectomy- Alternatives

Remember, hysterectomy is an irreversible or in another word, a permanent procedure. Therefore, discuss its needful with your doctor in detail before taking a final decision. If you do not have any serious medical conditions, then you may want to wait for some time to see how health is responding to alternatives other than hysterectomy.

1. Careful Monitoring Of The Condition:

Fibroids in the uterus are becoming very common nowadays and if you are suffering from this condition then you will want to wait and see. Occasionally, the fibroids tend to contract and disappear in due course.

2. Exercise Regularly:

In the case of uterine prolapse, Kegel exercises that help in strengthening the pelvic muscle floor will also help to hold the uterus in its place. Therefore, practicing Kegel exercise will help in improving this issue.

3. Medications:

If the condition is not very serious, then over-the-counter medications and those prescribed by your doctor itself is sufficient to cure the condition. Issues like endometriosis can be solved to a certain extent by means of hormone balancing medicines.

4. Surgery:

Depending on the severity of your condition, your doctor may suggest some minor surgeries instead of a hysterectomy. Some of the minor surgeries include –

  • Laparoscopic surgery for the treatment for Endometriosis. It is relatively a minor surgery with zero impact on the fertility.
  • D&C procedures for removing noncancerous thereby preventing excessive pain and bleeding
  • Surgeries intended to remove the fibroids (myomectomy). A woman has a fair chance of able to get pregnant after removing the fibroids through this procedure.
  • Non-invasive laparoscopy to shrink the fibroids (myolysis).

Types Of Hysterectomy

There are different types of hysterectomy procedures that are performed based on your medical needs. Some of the most common types are;

  • Total Hysterectomy: This involves the total removal of the uterus along with the cervix.
  • Partial Or Subtotal Hysterectomy: In this type of hysterectomy, the uterus is removed leaving the cervix
  • Radical Hysterectomy: This type of hysterectomy is conducted in women those who suffering from cervical cancer. Here, the uterus, cervix along with the tissues on both sides as well as the upper part of the vagina are removed.

Note: In all the above procedures, the ovaries and fallopian tube may or may not be removed. Only if there is a risk of developing ovarian cancer in the future, will the doctor remove the ovaries?

How Is Hysterectomy Performed?

There are many ways that a hysterectomy procedure is performed. This will be chosen by your doctor based on your medical condition and health history. Some ways are;

  • Abdominal Hysterectomy: Incision in the lower abdomen region.
  • Vaginal Hysterectomy: A small incision is made near your vagina which is sealed like an episiotomy after the procedure.
  •  Laparoscopic Hysterectomy: Surgery through laparoscopy with small cuts and incisions in the abdomen region or vagina.
  • Robotic Surgery: A robotic arm is used to make small cuts. This is similar to laparoscopy hysterectomy.

Can You Become Pregnant After Total And Partial Hysterectomy?

In general, a hysterectomy procedure will leave you with no chances of pregnancy post the surgery but there are extremely rare cases of women becoming pregnant post the procedure too. In full hysterectomy, the moment your uterus and cervix are removed you will enter into menopause stage and no eggs will be produced thereafter. But in the case of partial hysterectomy, your fallopian tubes and ovaries are not touched and there are slim chances of pregnancy. But even then, when an embryo is formed, there will be no place for it to implant as the womb is removed, this leads to ectopic pregnancy case which is quite risky.

No Uterus Means No Normal Pregnancy

Generally, if there is no uterus, then the pregnant woman cannot have a normal, full-term pregnancy. However, there is still a very slight chance that the fertilized egg gets implanted on to some other organ if the uterus is not present. This is known as ectopic pregnancy.

Ectopic Pregnancy After Hysterectomy

The chances are extremely very low. However, one in a million cases pregnancy cannot be ruled out completely. Here, the fertilized egg is attached to other organs in the absence of the uterus, which is known as ectopic pregnancy. This happens only in cases where the ovaries and fallopian tube is not removed during a total or partial hysterectomy. This type of pregnancy can cause ruptures in the fallopian tubes and ovaries leading to hemorrhages and hence is very risky.

Symptoms of Pregnancy After Hysterectomy

There are no prominent symptoms that can be seen in ectopic pregnancies which make the treatment difficult in the early stage. However, there are small signs that you may notice and want to get it checked with your doctor.

  • Light vaginal bleeding
  • Nausea and vomiting which is painful along with blood
  • Severe cramps in the abdomen
  • Neck, shoulder and rectum pain
  • Dizziness and extreme fatigue
  • Severe bleeding in case of internal rupture

Diagnosis And Treatment

An ultrasound and pelvic examination are conducted if an ectopic pregnancy is suspected. An emergency D&C surgery will be performed if there has been an internal rupture. But in case of no ruptures, then laparoscopy procedure is performed to remove the fetus to protect your health from a risky and life-threatening pregnancy.

Is It Possible To Become Pregnant After A Hysterectomy?

Generally, pregnancy is not possible after a hysterectomy. However, as described above in rare cases, pregnancy is possible and of course, it can turn out to be a life-threatening leading to termination of the pregnancy.

Having a hysterectomy is a life-changing decision and you may want to consider all the options open to you based on the severity of your medical condition. Getting pregnant even after hysterectomy can prove to be much more fatal to your health. If you need a child of yours after hysterectomy, surrogacy is the only option. You can go for it either by banking your egg or if your ovaries are not removed.