Skip to main content
ASK AN EXPERT
Got a question about a health story in the news or a health topic? Here's your chance to get an answer. Send us your questions about general health topics, diet and fitness and mental health. If your question is chosen, it could be featured on CNN.com's health page with an answer from one of our health experts, or by a participant in the CNNhealth community.




* CNN encourages you to contribute a question. By submitting a question, you agree to the following terms found below.
You may not post any unlawful, threatening, libelous, defamatory, obscene, pornographic or other material that would violate the law. By submitting your question, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your questions(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. CNN Privacy Statment.
Thank you for your question!

It will be reviewed and considered for posting on CNNHealth.com. Questions and comments are moderated by CNN and will not appear until after they have been reviewed and approved. Unfortunately, because of the voume of questions we receive, not all can be posted.

Submit another question or Go back to CNNHealth.com

Read answers from our experts: Living Well | Diet & Fitness | Mental Health | Conditions

Expert Q&A

Will liver scar tissue hurt my chances for a natural birth?

Asked by Inga Johnson, Lake Mary, Florida

Open quote
Close quote

I had a liver resection in late December 2008 because of a cavernous hemangioma (an abnormal buildup of blood vessels). I now have about a 10-inch scar from about center of my rib cage following along to the outer ribcage. Are there known complications of scar tissue like this? I am eight weeks pregnant and have started to wonder if the scar tissue may be an issue for natural birth and if there may be other issues that I should be aware of.

Expert Bio Picture

Conditions Expert Dr. Otis Brawley Chief Medical Officer,
American Cancer Society

Expert answer

Of course, I encourage you to discuss your concerns with your obstetrician. Perhaps I can give you some information to help in that discussion.

First let me explain that a hepatic hemangioma (also referred to as cavernous hemangioma) is a very common benign liver tumor. It is not known why these tumors occur. They are found in men and women of all ages. They usually have no symptoms and are frequently found when CT scans and ultrasounds are done for unrelated reasons.

Small asymptomatic hemangiomas are usually watched. Larger (greater than 5 centimeter in diameter) and symptomatic hemangiomas are treated.

The most common treatment is surgical removal. When a hemangioma is successfully removed, the overwhelming majority of patients do very well. Some patients will have multiple hemangiomas and only the largest one or the one causing symptoms is removed.

For women who have a known moderate to large hemangioma, there is concern that the high estrogenic levels found in women who are pregnant or taking oral contraceptives may encourage the growth of these hemangiomas. This is a concern and not a certainty.

As a result, controversy exists as to whether patients with known hemangiomas should be advised against pregnancy. For patients with hepatic hemangioma, full-term pregnancy without complication is the norm, but there have been a small number of women with hemangiomas that rupture and bleed during pregnancy. Some of these ruptured hemangiomas can be carefully watched and some need surgical resection.

In answer to your question, all surgeries in which the abdomen is entered carry a risk of postoperative adhesions, or the bowel sticking to itself. This is true for an appendectomy, a gallbladder surgery or a liver surgery. The risk is greatest for open surgeries and lower for laparoscopic surgery.

In general, a healthy pregnant woman with a history of a hemangioma resection should do well with the pregnancy. The risk of complications in delivery, be it by natural childbirth or by cesarean section delivery, are similar to that of a woman having had any successful abdominal surgery.

Adhesions are the result of tissue trauma and subsequent healing. They can cause abdominal pain, infertility, bowel obstruction, and they can increase the difficulty of subsequent surgical procedures. Bowel obstruction is the most common concern. In one large study, 3 of every 100 patients having an open abdominal surgery were diagnosed with symptomatic adhesions. Most are diagnosed within the first year after surgery.

To understand adhesions and obstruction, picture the gastrointestinal tract. It is a long tubular structure running from the mouth to the anus. The large and small intestine is a part of that tract and runs more than 25 feet long in the average adult. Imagine the large and small intestine like a garden hose coiled up in the abdominal cavity. It is possible for some of the bowel to have folds stuck to itself that can at times, due to shifting and movement, impede the flow of bowel content.

Acute bowel obstruction due to adhesions usually manifests itself with abdominal pain, nausea and vomiting. It is usually treated with hydration and bowel rest and can resolve with no further ill effects. Severe obstruction and especially recurring obstruction may be treated with surgical removal of the blockage.

More Q&A

  • CNN's Medical UnitCNN's medical unit brings you the best experts available to answer your questions about current events and health issues that matter most to you.
Is secondhand smoke really that risky?asked by: Asked by David; Tampa, Florida
Can a nerve stimulator stop my back pain?asked by: Asked by Larry; New York
Is the inability of cancer patients to eat a concern?asked by: Steve Snodgrass; Bowling Green, Kentucky

CNN Comment Policy: CNN encourages you to add a comment to this discussion. You may not post any unlawful, threatening, defamatory, obscene, pornographic or other material that would violate the law. All comments should be relevant to the topic and remain respectful of other authors and commenters. You are solely responsible for your own comments, the consequences of posting those comments, and the consequences of any reliance by you on the comments of others. By submitting your comment, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your comment(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. CNN Privacy Statement.

The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.