Only a few gynecologic issues can increase risk of a subsequent pregnancy.

Prior uterine surgery: if you have had surgery for removal of fibroids (myomectomy), especially if the surgery entered the uterine cavity and was in the upper portion of the uterus, then it may not be safe for you to undergo labor, and an elective planned cesarean section may be recommended.

Uterine anomalies: these include double (bicornuate or didelphys) uterus, uterine septum, and abnormal uterine shape. There is an increased risk of both early and late miscarriage with these uterine anomalies, and close monitoring for premature labor will be advised. A retroverted or "tipped" uterus is NOT associated with any increased risk for miscarriage or early labor.

Prior abortion in the second trimester: there is some evidence that midtrimester abortion, done for fetal demise, severe fetal anomaly, or electively, can increase the risk of premature delivery in subsequent pregnancies. There is NO increased risk from having early abortions or dilation and curettage (D&C) procedures. A history of late abortion may cause your physician to advise frequent checks of your cervix during pregnancy, by manual exam or by vaginal ultrasound, to detect early changes.

Cervical surgery to remove precancerous tissue:a "cone biopsy" or a "LEEP" procedure removes cervical tissue and may cause a subsequent weakness of the cervix, leading to early dilation and pregnancy loss. If you have a history of these procedures, assessment of your cervix will be done and in some cases a retaining stitch (cervical cerclage) may be advised.

Prior hydatidiform mole: women who have this abnormal placental growth removed are at risk of metastasis (spreading) and are advised not to get pregnant for six months to a year after removal. This is because the serum pregnancy test is a 100% accurate measure of whether there has been spread or not, and a pregnancy prevents the use of this test.

Pregnancy with IUD in place: the IUD should be removed if possible, which may precipitate miscarriage; but if the first trimester passes without incident, there is no significant risk to the baby.

Gynecologic issues which do NOT pose any risk to a pregnancy or to the baby include:

• Being on oral contraceptives when pregnancy occurs
• Endometriosis
• Removal of an ovary or tube
• History of pelvic infection
• Failure of Plan B
• Hysteroscopy or laparoscopy
• Retroverted or "tipped" uterus