The experience of metroplasty at the stage of delivery in pregnant women with two cesarean section operations in the anamnesis
- Authors: Tarasova K.1, Musin I.I.1, Yaschuk A.G.1
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Affiliations:
- Bashkir State Medical University
- Section: Original study articles
- Submitted: 24.12.2023
- Accepted: 03.02.2024
- Published: 04.06.2024
- URL: https://archivog.com/2313-8726/article/view/624957
- DOI: https://doi.org/10.17816/aog624957
- ID: 624957
Cite item
Abstract
The purpose of our study is to evaluate the effectiveness of metroplasty at the stage of abdominal delivery in women with a history of two cesarean section operations
Materials and methods. From 2020 to 2022, 150 pregnant women were examined. The patients were divided into 3 groups: the first group - pregnant women with a history of cesarean section, the second group – pregnant women with two cesarean sections. In these groups, metroplasty was performed at the stage of delivery. The third control group consisted of pregnant women with a history of two cesarean sections who underwent surgical delivery without excision of scar tissue in the lower segment.
Metroplasty was performed before fetal extraction with a whole fetal bladder in accordance with the patent "Method of metroplasty during operative delivery in women with two or more cesarean sections".
In order to study the dynamics of changes in scar thickness, all women underwent ultrasound examination 2 hours later, on the third day after delivery, and 6 months after delivery.
The results of the study. Resection of the scar area on the uterus during repeated cesarean section improves the residual thickness of the myometrium, which is determined by ultrasound 6 months after surgery. This technique allows you to form a functionally consistent scar on the uterus after two cesarean section operations.
Full Text
About the authors
Kristina Tarasova
Bashkir State Medical University
Author for correspondence.
Email: krisval2017@yandex.ru
ORCID iD: 0000-0002-9807-5945
врач акушер-гинеколог, аспирант
Russian FederationIlnur I. Musin
Bashkir State Medical University
Email: ilnur-musin@yandex.ru
PhD, Associate Professor, Department of obstetrics and gynecology with IPE course
Alfiya G. Yaschuk
Bashkir State Medical University
Email: alfiya_galimovna@mail.ru
Dr. Med. Sci., Professor, Head of the Department of obstetrics and gynecology with IPE course
References
- Literature
- Ye J, Betrán AP, Guerrero Vela M, Souza JP, Zhang J. Searching for the optimal rate of medically necessary cesarean delivery. Birth. 2014 Sep;41(3):237-44. doi: 10.1111/birt.12104. Epub 2014 Apr 11. PMID: 24720614.
- Tulandi T, Cohen A. Emerging Manifestations of Cesarean Scar Defect in Reproductive-aged Women. J Minim Invasive Gynecol. 2016 Sep-Oct;23(6):893-902. doi: 10.1016/j.jmig.2016.06.020. Epub 2016 Jul 5. PMID: 27393285.
- Zemskova N.Yu., Chechneva M.A., Petrukhin V.A., Lukashenko S.Yu. Ultrasound examination of the uterine scar after cesarean section in the prognosis of pregnancy outcome. Obstetrics and gynecology. 2020; 10: 99-104 https://dx.doi.org/10.18565/aig.2020.10.99-104
- Vuchenovich Yu.D., Novikova V.A., Kostin I.N., Radzinsky V.E. Risks of scar failure and attempts at vaginal delivery after cesarean section // Obstetrics and gynecology: news, opinions, training. 2019. Vol. 7, No. 3. Appendix. pp. 93-100. doi: 10.24411/2303-9698-2019-13913
- Sidorova, T. A. Risk factors and mechanisms of formation of scar defects on the uterus after cesarean section / T. A. Sidorova, S. A. Martynov // Gynecology. – 2022. – Vol. 24, No. 1. – pp. 11-17. – doi: 10.26442/20795696.2022.1.201356
- Clinical recommendations. Postoperative scar on the uterus, requiring the provision of medical care to the mother during pregnancy, childbirth and the postpartum period, 2021
- Marshall NE, Fu R, Guise JM. Impact of multiple cesarean deliveries on maternal morbidity: a systematic review. Am J Obstet Gynecol. 2011 Sep;205(3):262.e1-8. doi: 10.1016/j.ajog.2011.06.035. Epub 2011 Jun 15. PMID: 22071057.
- Yaman Tunc S, Agacayak E, Sak S, Basaranoglu S, Goruk NY, Turgut A, Tay H, Elci E, Gul T. Multiple repeat caesarean deliveries: do they increase maternal and neonatal morbidity? J Matern Fetal Neonatal Med. 2017 Mar;30(6):739-744. doi: 10.1080/14767058.2016.1183638. Epub 2016 May 20. PMID: 27125601.
- Vaginal delivery or cesarean section - a conscious choice of an obstetrician / L. S. Logutova, S. N. Buyanova, A. L. Gridchik [et al.] // Obstetrics and gynecology. - 2020. – No. 7. – pp. 135-142. – doi: 10.18565/aig.2020.7.135-142.
- Kok N, Wiersma IC, Opmeer BC, de Graaf IM, Mol BW, Pajkrt E. Sonographic measurement of lower uterine segment thickness to predict uterine rupture during a trial of labor in women with previous Cesarean section: a meta-analysis. Ultrasound Obstet Gynecol. 2013 Aug;42(2):132-9. doi: 10.1002/uog.12479. PMID: 23576473.
- Einerson BD, Comstock J, Silver RM, Branch DW, Woodward PJ, Kennedy A. Placenta Accreta Spectrum Disorder: Uterine Dehiscence, Not Placental Invasion. Obstet Gynecol. 2020 May;135(5):1104-1111. doi: 10.1097/AOG.0000000000003793. PMID: 32282597
- Barinov S.V., Bindyuk A.V., Ralko V.V., Grebenyuk O.A., Ilinykh I.M. On the issue of delivery of pregnant women with a scar on the uterus. Russian bulletin of the obstetrician-gynecologist. 2015;15(4):29‑33
- An innovative approach to studying the condition of the scar on the uterus after cesarean section surgery based on a comparative study / A. N. Strizhakov, I. V. Ignatko, A. A. Churganova, A. G. Aslanov // Bulletin of the Russian Academy of Medical Sciences. – 2021. – Vol. 76, No. 5. – pp. 429-435. – doi: 10.15690/vramn1291
- Debatable issues of uterine scar insolvency in the era of the cesarean section epidemic / D. V. Polyanin, A. A. Mikhelson, O. A. Melkozerova, K. D. Lukyanova // Ural Medical Journal. – 2019. – № 5(173). – Pp. 17-23. – doi: 10.25694/URMJ.2019.05.30.
- Yametova N.M., Tskhai V.B., Domracheva M.Ya. Repeated cesarean section surgery in women with two or more uterine scars. Medical Bulletin of the South of Russia. 2021;12(1):X-X. doi: 10.21886/2219-8075-2021-12-3-86-91
- THE EXPERIENCE OF SURGICAL CORRECTION OF AN INCOMPETENT SCAR ON THE UTERUS AFTER CESAREAN SECTION AT THE STAGE OF PRE-GRAVIDAR PREPARATION. Malysheva A.A., Matukhin V.I., Reznik V.A., Rukhlyada N.N., Taits A.N. Problems of reproduction. 2018. Vol. 24. No. 6. pp. 46-50.
- Laparoscopic metroplasty in case of an incompetent scar on the uterus after cesarean section / H. B. Balashova, L. N. Shcherbakova, O. B. Panina, A. E. Bugerenko // Issues of gynecology, obstetrics and perinatology. - 2022. – Vol. 21, No. 4. – pp. 126-132. – doi: 10.20953/1726-16782022-4-126-132
- The true growth of the placenta / O. B. Kalinkina, Yu. V. Tezikov, I. S. Lipatov [et al.] // Practical medicine. - 2020. – vol. 18, No. 2. – pp. 71-73.
- Surgical tactics for placenta accretion with different depth of invasion / R. G. Shmakov, M. M. Pirogova, O. N. Vasilchenko [et al.] // Obstetrics and gynecology. - 2020. – No. 1. – pp. 78-82. – doi: 10.18565/aig.2020.1.78-82.
- Organ-preserving surgical treatment for placenta previa and its ingrowth into the uterine scar (clinical observation) / A. Y. Ralnikova, V. F. Refugee, B. V. Arakelyan, K. A. Gabelova // Obstetrics and gynecology of St. Petersburg. – 2019. – No. 3-4. – pp. 66-70
- SPREADING OF THE SCAR ON THE UTERUS AFTER CESAREAN SECTION. Kurtzer M.A., Breslav I.Yu., Barykina O.P., Scriabin N.V., Nigmatullina E.R. Obstetrics and gynecology. 2022. No. 2. pp. 59-64.
- A.G. Yaschuk, K.V. Kudryashova, I.I. Musin. The method of metroplasty during operative delivery in women with two or more cesarean section operations in the anamnesis: patent No.2790787 Ros. Federation; declared: 07/29/2022; published: 02/28/2023. Byul. No. RU 2790787 C1
- Baranovskaya E.I. Isthmocele formation after cesarean section. Russian bulletin of the obstetrician-gynecologist. 2023;23(5):32‑37.