Q: I am a 35 years old working female and have a 7 years old son. Three years back I had a miscarriage due to high blood pressure. In both cases I underwent for a c-section. Since then I am under medication and now my blood pressure is under control. I have done complete health check up and all reports are normal. Now I am planning to conceive again. My question is can I proceed as I already have had two caesareans earlier? How can I maintain a normal BP throughout pregnancy?

A:Two C-sections is not a contraindication for another pregnancy. However, the gynaecologist who operated on you the 2nd time is the best person to tell you whether or not to conceive as she would know how the uterus was at repeat operation.

The 3rd C-section does carry increased surgical risks as there would be adhesions between uterus and abdominal wall and, more importantly, the bladder. Therefore, you should be under the care of a highly experienced gynaecologist working in a tertiary hospital with all facilities available to take care of you should your BP rise again, and in case preterm delivery is required, one with good neonatal ICU facilities . Make sure your blood sugars are normal and your kidney function tests are normal before conceiving. Also, you must inform your physician (medical specialist) taking care of your BP that you intend to conceive. He may need to change your drugs if there is a possibility of the drugs having any adverse effect on pregnancy or baby.