Bleeding after ETHMOIDECTOMY, TURBINECTOMY due to injury.

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

Expert:  Dr. Aarti Vazirani replied 4 Days.

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.

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Patient replied :

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!


Expert:  Dr. Aarti Vazirani replied 3 Days.

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.

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