Resolved question:
Four weeks ago I had endoscopic sinus surgery, specially a complete ethmoidectomy and bilateral turbinectomies. Three days ago a child accidentally hit me in the nose with their forehead. My nose immediately bled, followed by swelling and bruising. There is still some minor deformity and I cannot breathe as well out of my right nostril. I had an xray taken, and I believe I see a small fracture of the nasal bone. However, there are striations below the nasal bone that I don't understand. Could those lines be related to my recent surgery, or is that cartiledge or septal injury?
Submitted:
4 Days
Category:
OBGYN
Hello
Thanks for posting your query at DoctorSpring.com
Thank you for the indepth and perceptive account attached.
I would do my best to provide an obstetrician's perspective to this issue.
1. Regarding the cervical issue, you have had regular normal Paps, so that is not a concern at all.
2. You have not had any ominous bleeding or history of miscarriages, so that too is not a concern.
3. To answer your queries one by one - after the age of 35, what are the risks of having a baby ( in general, because you are a reasonably healthy individual, so you do not have any heightened person - specific risks )
- Increased chance of difficulty in conception ( after 35, the ovarian reserve - capacity of ovaries to make good number and quality of eggs , declines, so fertility in general declines )
- Increased risk of miscarriages
- Increased risk of medical complications ( diabetes, hypertension during pregnancy )
- Increased risk of prolonged and difficult labour and higher risk of C section
- Increased risk of congenital anomalies in offspring
4. Specific health risks for you might include - higher chances of developing hypertension during pregnancy, as you had it once, higher risk of repeat C section considering you had a prior prolonged labour and resultant C section
5. One is eligible for a VBAC at any age, and it can be attempted, chances of success decline with age, there is no absolute contra indication to attempting a VBAC.
6. There is no life threatening risk for you during future childbirth, many women conceive and deliver at the age you intend to.
In my medical and professional opinion - I would tell you this -
If you plan to have more kids, do it now, not after 5 - 8 years.
33 is still a wonderful age to have kids, and considerably safer in all aspects than having one at 38 or later.
All the best
Please feel free to discuss further.
Thank you! this information was very helpful. Do you know the average overal maternal mortality rate for repeat c-sections in women over 35? Do you know the average overal maternal mortality rate for v-bac in woman over 35? Thank you!
The exact rates vary from study to study, but in general, the maternal mortality rates are very low in either group.
Some studies quote VBAC as being safer ( particularly in terms of the baby's survival ) while most quote an elective C section as being safer for the mother.
In both groups, mortality is slightly higher for women over 35.
I do not have the exact statistics at hand, but it is not a figure that should concern you, as long as you are under the care of a vigilant OB team.
Regards.