The Method of Remodelling of the Inconsistent Scar on the Uterus During Cesarean Section Operation


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Abstract

Relevance Following up of a pregnant women with a scar on a uterus is one of actual problems of modern obstetrics. Scarring of uterus wall increase probability of complications, such as fetoplacental insufficiency, fetal hypoxia, threat of interruption of pregnancy. Special danger to life of mother and fetus is represented by an inconsistent scar on a uterus in connection with probability of a rupture of a uterus at pregnancy or childbirth. Restoration of a uterus wound quite often becomes complicated by cutting of threads through fragile scar tissue, bleeding and repeated formation of an inconsistent scar. The purpose of the study was development of a technique of remodeling of an inconsistent scar on a uterus, allowing to restore anatomic and functional full value of the lower segment of a uterus. Materials and methods Research of 122 pregnant women with a inconsistent scar on a uterus who were divided into two groups is conducted. The control group included 57 patients at whom the uterus during Cesarean section was taken in by a traditional technique. The main group was made by 65 women at whom the offered technique of remodeling of a scar on a uterus was used. Results and their discussion During use of the offered technique in comparison with traditional, additional haemostatic sutures on a uterus were imposed 3 times less often, need for application of uterotonic medications was decreased, the total amount of blood loss decreased at operation. By the 4 days after the delivery the average thickness of a scar on a uterus in the main group varied from 7,2 to 8,3 mm, in control group – from 2,9 to 3,4 mm. Important difference was absence of early postnatal bleedings and endometritis at patients in the main group that promoted more favorable current of the postnatal period and formation of a consistent scar on a uterus.

About the authors

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Author for correspondence.
Email: archer-206@ya.ru
M.D., Assistant of the Department Obstetrics and Gynecology №2 of VSMA; E-mail

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: hypoxia@mail.ru
M.D., Assistant professor of the Department Obstetrics and Gynecology №2 of VSMA

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: val@obg.vrn.ru
Ph.D., Prof., Head of the Department Obstetrics and Gynecology №2 of VSMA

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