Minta pendpt semua..nak dgr ckp doc ke..nak dgr ckp hati...csec/normal?

tinaz

Salam kpd semua forumers...tinaz ni dh lama betul x berporem..selalu baca je mls nk porem2..
Tinaz ni skang buntu dah nak pikir...Now 2nd pregnant.. dh 37weeks..1st dulu csec sebab baby distress..lemas ms contraction...even blm kuar tanda2 nak besalin pun..tak tau sakit contraction pun...
Prob 2nd preg ni pulak uri bwh minor thp 1(placenta posterior)..sikit je kacau kt serviks tu bout 4cm...

Now tinaz checkup dgn prof dr noraihan under private wing kat spital putrajaya...since prev history csec due to baby distress, now plak ada uri bwh..so dia x advise for normal..dia mmg suh csec je...yang tinaz ni pulak mmg nak sesgt go for normal...
Sebelum ni check up di UMRA kt s.alm..disebabkan tinaz nk try normal doc suh pi spital gov je, diorg x nak accept sebab byk risk n diorg xde blood bank if anything happen..tu yg decide pi checkup kt putrajy lak...

Skang ni betul2 buntu..nk dgr ckp doc terus potong or try normal dulu...bila2 dh betul2 x blh potong pun takpe la...itu yg tinaz tgh pikir skang..rs nak buat mcm tu baru la puas hati if kita dh cuba tp x blh...
Tp doc kata awk ni berani betul pertaruhkan risiko yg ada...Masalah skang doc x nk cuba, dia kata byk risiko, dia takut..lbh baik safe delivery...adehhhhh
Yang tinaz plak mmg dh ready nak berdepan dgn risiko2 tu...risiko pertama, bekas parutan lama blh pecah dan menyebabkab pendarahan, risiko kedua juga pendarahan sebab uri di bwh...dia kt bahaya nyawa tinaz n baby...if uri lekat dekat parutan lama terpaksa buang semua uterus...lagi risiko dia ckp prev history yg dulu baby distress n mungkin blh berlaku lagi..dia takut ms dlm labor tu baby distress...adeeehhhh...buntu..buntu...

If ikut kata hati ni, kuat mengatakan yg tinaz ni blh normal...usaha n tawakkal mmg hari2 dibuat..now berserah je pd allah..yg tinaz terharu sgt hubby sanggup puasa sunat tiap2 hr senin n khamis just only for me..air penawar tuk uri bwh, selusuh pun dah amik..nenek urut tu pegang perut buat 1st time mmg dia kata uri bwh, then tinaz pi 2 kali bg dia tolak sikit uri..dia kata insyaallah blh try normal..

Maaf la panjang sgt tinaz tulis...minta pendapat sume tolong la...mcm mana nk buat ni next dh msk 38weeks, lg sekali nk checkup tgk mcm mana..i need to decide...susah hati betul la...

[ Last edited by  tinaz at 12-2-2009 09:00 AM ]

ampersan

my advice ikut la nasihat doc.
seeloknya jgn la ambik risiko
ceasar pon apa salahnya
kalau itu yg terbaik

xda apa yg menariknya dgn bersalin normal
walaupun ramai yg suka / nak sgt try for normal
tapi bersalin normal bukan la sesenang bunyinya

dalnas

kalau saya..saya ikut nasihat doc..

dalnas

btw...baru je tahu hosp putrajaya ada private wing...

hmmm...

d1nonly

sedihnya dengar cerita tinaz...

tp d1 rasa better tinaz dgr ckp doc. diorg lagi tau kan. macam2 leh jadi masa bersalin nanti.. (cakap cam pernah bersalin je.. baru 1st baby ni... )

d1 doakan tinaz n baby ok.. amin....

dalnas

last year my opismate pun confused nak bersalin normal atau csec. Tp dah lupa da sebab dia..dia rujuk ngan dr hamid arshad....

tp seingat dulu, dr hamid tu ckp...'kita pilih cara yang paling selamat untuk ibu dan anak'. Walaupun betul boleh cuba...

last-last my fren tu go for csec..minggu 38 dah bersalin...tarikh pilih sendiri..

afzanieza

better ikut cakap dr la... uri bawah type 1 kira bahaya gak... walaupun tak mengalami pendarahan masa mengandung..... biasanya kalo uri bawah memang dr tak kasi deliver normal rasanya laaa....

tinaz

  bersalin mmg x best kan..huhuhuhu, tp sakit kena potong ni tinaz dah tak sanggup nk tanggung...
In my life dah 3 kali perut ni operate..tu yg nk sesgt2 try normal kali ni...
Dulu ms darjah 5 dah operate ada hernia, pastu 3 1/2 thn lps csec delivery, last skali Dec 2007 operate buang cycst plak...huhuhuuh byk haku kena potong...

kali ni if potong gak...haaaaaaaaaaaaaa ..yg tinaz taknak sgt tu sebabnya bila perut/dalaman kita di operate n dah diusik byk kali byk penyakit lain akan ada plak...mcm doc yg lepas2 ckp (siti esah, delaila, noraini..etc) bila dalaman kita dah diusik/ dah dipotong2 akan tinggal parut di dlm just like parut kat luar..dan akan mengundang pelbagai masalah...female organ kita kan complicated skit...semua dekat2 antara2 satu sama lain..so complication tersalah potong sgt lah tinggi, disebabkan dalaman kita dah x seperti biasa..biasa bercantum2 dan lari..itula explaination doc.

Tinaz suffer sakit cyst about 1 yr..raptured left ovarian cyst..bila dah buang cyst pun sakit yg sama tetap ada, sebab ada parutan dlm yg mgg x blh hilang n ovary position yg sepatutnya floating tp dah melekat dgn rahim...itu la complication bila dalaman kita dah di usik2...mcm2 kan...wallahulam semua kuasa Allah...

tinaz

thanks d1...mmg tawakkal je skang ni....

dianaris

tinaz dah tanya other gynae for second or third opinion..?
satu lagi jarak antara anak 1st dgn yg bakal lahir based on EDD tinaz ni bp jauh beza?
mmg betul kesan csect or operation yg tinaz nyatakan kat post awak ni..
apa kata u gather info psl placenta posteriur.. google psl effect dia.. tahap danger dia kalau opt for normal..
sblm ni, ada tanya gynae tak mcm mana kalau tinaz nak ambil epidural utk normal delivery, bukan ke proses bersalin dan betulkan kedudukan uri shud b easier since epidural dah bg kebas separuh badan and all that..?

dari first post tu, tinaz dh bgtau yg gynae kat putrajaya spital ni takut ambil risiko..
ada tak gynae tinaz ni bgtau reason2 lain naper tinaz kena csect jugak? atau still samar2 dia punya reason.. bukan apa, at least boleh gak share info dan manalah tau ada reason yg lebih concrete gynae tinaz ni bg..

tinaz

actually diana, ni second doc la, 1st dulu ngan doc Ummul& Rafi kat UMRA s.alam... Since diorg ni pusat bersalin je..so diorg x nk la accept me yg berisiko ni if opt for normal delivery...csec diorg nk la accept...
Ada gak ajk hb pi cr doc lain plak..tp dia mcm x mau...ni pun dh second doc katanya..byk dah duit dia habis..huhuhuh sian dia, tinaz plak x keje..adehhhh

Gap dgn ank yg 1st jauh gak..nak msk 4 thn dah...mcm yg tinaz citer kt ats tu, lps csec yg 1st, tinaz buat laporoscopic surgery plak buang cyst ovary...

Pasal epidural tu x pernah tanya, sebab x terfikir pun nak amik...nak rs pure sakit bersalin..huhuhuh
Dulukan ms nak csec yg 1st tu dah kena cucuk epidural skali, so i think if normal ni x nak amik...seram kena cucuk belakang..sakit...

Emm xde reason lain da pasal dia suh csec ni...sebab ada prev csec history n placenta tu la...oh ada lagi satu dia sebut uri tinaz ni looks not so healthy..dia ckp placenta calsification...tru scan tu nmpk uri cam byk putih2..dia kata uri tu looks mature..huh mcm2 kan

phoebe

emmm padaku better ikut pendapat gynae
gynae tu dah byk handle kes
and dorang mmg kalo boleh tak nak tanggung risk tgi
yela nanti in between life nak kena selamatkan ke etc
susah gak dorang
so rasanya go for the safer way
normal pun tak semudah di sangka
ada org nak go for caesar jek coz tak sanggup contraction
contraction tu mmg sangat2 sakit especially if kena induce ke apa
so i thinkl go for the safer way...
rather than instincts sendiri
kite ni bkn medicacl people

ehem_ehem79

yurp tina ... better ekut advice gynea ..
lagipun tina dah 3kali ceaser ... bahaya jugak tue nak push ..

derang tahu yang terbaik utk kita .. atau pi 3rd opinion ke Dr. Hamid Arsyad teruss .. tengok Pak hamid cakap apa ....

notebook

tinaz..my opinion...baik u go for c-zer....
note dulu ada gak komplikasi tapi idok la sekrtikal u...
doctor bg option w/pon ikutkan dia suggestkan c-zer...
bila mengenangkan "baik/keselamatan tuk ibu & anak", note pilih czer....alhamdulillah,slamat semuanya....

tinaz

Types of placenta previa
Placenta previa is medically categorised into 4 grades of severity. These are:

Grade 1 or minor.
Where part of the placenta is implanted in the lower segment of the uterus, but the edge is more than 5cms (2 inches) away from the woman's cervix. Most of the placenta is situated normally, in the upper segment of the uterus. The cervix needs to dilate 10 cms in labour, usually 5cms each way, for the woman to give birth vaginally.
Grade 1 Placenta Previa Image 4-42 shows a Grade 1 Placenta Previa.
[img][/img]
Grade 2 also minor.
Most of the placenta is implanted in the lower segment, and the edge of the placenta touches the edge of the cervical opening, but does not cover it.
Grade 2 Placenta Previa Image 4-43 shows a Grade 2 Placenta Previa.
[img][/img]
Grade 3 or major.
The placenta is implanted in the lower segment and part of the placenta covers some of the cervical opening.
Grade 3 Placenta Previa Image 4-44 shows a Grade 3 Placenta Previa.
[img][/img]
Grade 4 also major.
The placenta totally covers the woman's cervix.
Grade 4 Placenta Previa Image 4-45 shows a Grade 4 Placenta Previa.
[img][/img]

There is another type of placenta previa, where most of the placental tissue is situated in the upper segment, but there is a small piece of placenta that implants away from the main body of the placenta, over or near the cervix. This is a satellite lobe or succenturiate lobe and is connected to the main placenta by a large blood vessel running through the sac or membrane . This is rare and may be difficult to detect on ultrasound.

Succenturiate Lobe Image 4-46 shows a placenta with a Succenturiate lobe.
[img][/img]

Care and treatments for vasa previa

Vasa previa is when unprotected blood vessels implanted in the membranes or sac run from the placenta across the inside of the woman's cervix. This variation occurs when the placenta grows in an unusual way, either as a succenturiate or bi-polar formation or as a velamentous insertion of the cord. Vasa previa is very rare, thought to occur for about 1 in 2000 - 3000 pregnancies (0.0005 - 0.0003%).

Succenturiate formation is when the placenta has a satellite lobe that implants away from the main body of the placenta, but is connected to the placenta by a large blood vessel (or several vessels) implanted in the amniotic sac or membrane. A bi-polar or bipartite placenta is where the placenta grows as two equal-sized lobes, joined by a blood vessel (or more than one blood vessel).

Succenturiate Lobe Image 4-46 shows a placenta with a succenturiate lobe and the blood vessel trailing through the sac or membrane.
[img][/img]

A velamentous insertion is where the cord implants in the membrane of the amniotic sac instead of the placenta. Large blood vessels run though the membrane to the placenta. This occurs in about 1% of singleton pregnancies and up to 7% of twin pregnancies.

Velamentous insertion Image 4-47 shows a placenta with a velamentous Insertion.
[img][/img]
We don't know exactly why vasa previa forms, but it is often associated with a low-lying placenta or a previous caesarean birth, women who smoke, multiple pregnancies and assisted conceptions, such as IVF.
NOTE: These two types of placenta formations do not necessarily mean there is definitely vasa previa, especially if the placenta is implanted high in the uterus, away from the cervix. If there is no vasa previa, then the pregnancy and birth can generally progress normally.

Care and treatments for vasa previa

If vasa previa is present, there is the chance that the blood vessel(s) could rupture when the waters break, or if a caregiver performs an artificial rupture of the membranes (ARM) to induce or augment labour. This is potentially life-threatening for the baby, as the blood loss through this broken blood vessel can be rapid and severe. Another problem can be compression of the blood vessel by the baby as it descends through the birth canal during labour, possibly reducing blood supply and oxygen from the placenta and cord.
Unfortunately in many cases, vasa previa is not diagnosed until heavy vaginal bleeding occurs, usually when the waters break during late pregnancy or during labour. A routine ultrasound after 16 weeks of pregnancy may detect vasa previa, but even the best ultrasonographer can miss seeing the blood vessel, because it is not an easy feature to visualise on ultrasound, especially if done through the abdomen (rather than vaginally). If a woman has a low-lying placenta or twins or triplets, the caregiver may order a special colour Doppler ultrasound which can track blood flow through the blood vessel. This is very accurate for detecting vasa previa, but this type of technology is not used routinely and is not widely available.
If vasa previa is diagnosed during pregnancy, the caregiver may make several recommendations. These can include stopping work after 24 to 28 weeks, perhaps bed rest and avoiding sex during the last 12 weeks of pregnancy, as well as no internal vaginal examinations from caregivers. They may also suggest staying in hospital during late pregnancy in case the waters break and bleeding starts. If this occurs a caesarean operation would be performed immediately.
Generally, the baby is delivered by planned caesarean at around 35 to 37 weeks of pregnancy. This timing is aimed to be late enough for the baby to be physically mature and not require special intensive care treatments, but early enough so that labour is unlikely to start spontaneously, with the risk of the waters breaking. Vasa previa has an extremely low chance of occurring again with subsequent pregnancies.

tinaz

mcm mana ekk..nak hilangkan perasaan x puas hati ni...huhuhuhu
rs terkilan n x puas hati sgt2 ni...sebab tak try....adehhh susahnya la nak beranak ni...huhuhuhu

Nisda_

ok tinaz..nak bagi pendapat gak..

saya pun elective c-section, gynea dr. hamid arshat. Pada mula2 memang inginkan sangat normal, tapi bila dah 34weeks baby songsang, 36weeks ok balik position, tapi doctor kata, kalau ikut kedudukan baby dlm perut kemungkinan besar saya kene c-section, fikir punya fikir last2 saya agreed. Minta referral letter dari dr. hamid, balik ke klang, jumpa gynea di sri kota, sebab kalau operate saya nak dekat dgn rumah, mak..senang ada orang tengok kan. gynea specialist kat klang pun advise suruh elective c-section, pilih hari, 38weeks cut. Alhamdullilah saya ikut kata doctor, memang saya tak boleh normal, kepala baby tak boleh turun langsung sebab ada fibord.

My SIL case sama seperti u, uri di bawah, dah selamat pun elective c-section kat spital kerajaan, ini pun dpt referrel letter dari private spital sebab diorang bukan tak mau ambik tapi takut adik saya tak boleh tanggung cost operation nanti sebab perlukan darah at least 10 beg, cost kemungkinan kata gynea makan puluh ribu. Itu pun dia tunggu hingga 40weeks to decide, baby pun dah berak dlm perut tapi nasib everything went well.

baby102

Originally posted by tinaz at 12-2-2009 10:42 AM


mcm mana ekk..nak hilangkan perasaan x puas hati ni...huhuhuhu
rs terkilan n x puas hati sgt2 ni...sebab tak try....adehhh susahnya la nak beranak ni...huhuhuhu

tak payahla nak rasa tak puas hati sbb tak leh normal.  normal ke csect ke yg penting semua selamat. jgn ambik risiiko yg boleh membahayakan nyawa.  apa salahnya csect,  mmgla sakit kena operate tapi yg paling penting keselamatan diri kita.

i pun both pregnancy kena csect.

tinaz

thanks nisda n all...

Nisda nk tanya mahal tak checkup dgn hamid arshat? Thanks sharing some exp with me.. if confirm csec tinaz nak pi buat kt spital dekat je...duk kt area jln kebun klang tp pi checkup kt putrajaya..ni gara2 nk try normal n cr spital gov yg elok skit selain HTAR tu...huhuhuhu
jauh plak nk thn sakit kena operate tukan if dr putrajy...dulu operate kt SMC je...

Nisda_

Hehe..orang klang rupanya..smlm baru pergi jalan kebun visit SIL and babynya.

Setiap kali check-up dgn dr. hamid dalam 100-250 includes ubat, vitamin.
Dr. Hamid very good and gentle, suka sgt dgn dia tapi takde rezeki nak salin dgn dia. tapi alhamdullilah gynea saya di klang, Dr. Soh pun very good and attentive.

Jauhnya nak buat di putrajaya, tapi kalau elective c-section takpe lagi kalau normal takut tak sempat lak kan. HTAR memang service so-so aje, hehe. Why not u try dgn my gynea, Dr. Soh, clinic dia di depan giant bukit tinggi, bersalin di sri kota medical centre. Dr. Soh prefer Sri Kota sebab service better than pantai klang. Tapi my sil hari tu saya suruh jumpa dr. soh, dia yang kata kalau kes uri di bawah, kalau di klang hanya private like sri kota & pantai boleh terima sebab diorang ada bank darah dan boleh handle major operation seperti spital kerajaan.

[ Last edited by  Nisda_ at 12-2-2009 11:25 AM ]