Metroplasty in the delivery of pregnant women with a history of two cesarean sections

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Abstract

AIM: This study aimed to evaluate the effectiveness of metroplasty at the stage of abdominal delivery in women who had undergone two cesarean section operations.

MATERIALS AND METHODS: Between 2020 and 2022, 150 pregnant women were examined. The patients were divided into three groups: the first group included pregnant women who had undergone one cesarean section, and the second group included those with two operations. In these groups, metroplasty was performed at the stage of delivery. The third group (control group) included pregnant women with a history of two cesarean sections who underwent surgical delivery without excision of the scar tissue in the lower segment. Metroplasty was performed before fetal retrieval with the whole fetal bladder in accordance with the patent “method of metroplasty during operative delivery in women with two or more cesarean sections.” To assess the dynamics of changes in scar thickness, all women underwent ultrasound examination 2 h, 3 days, and 6 months after delivery.

RESULTS: Resection of the scar area on the uterus during repeated cesarean sections improved the residual thickness of the myometrium, which was determined by ultrasound examination 6 months after the operation.

CONCLUSION: The proposed technique allows the formation of a functionally sound scar on the uterus after two cesarean sections.

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About the authors

Kristina V. Tarasova

Bashkir State Medical University

Author for correspondence.
Email: krisval2017@yandex.ru
ORCID iD: 0000-0002-9807-5945

Graduate Student

Russian Federation, Ufa

Ilnur I. Musin

Bashkir State Medical University

Email: ilnur-musin@yandex.ru
ORCID iD: 0000-0001-5520-5845

MD, Dr. Sci. (Medicine), Assistant Professor

Russian Federation, Ufa

Alfiya G. Yaschuk

Bashkir State Medical University

Email: alfiya_galimovna@mail.ru
ORCID iD: 0000-0003-2645-1662

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Ufa

Edvard A. Berg

Bashkir State Medical University

Email: aig.eaberg@gmail.com
ORCID iD: 0000-0002-2028-7796

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, Ufa

Svetlana F. Nasyrova

Bashkir State Medical University

Email: ufa863@mail.ru
ORCID iD: 0000-0002-2313-7232

Cand. Sci. (Medicine), Assistant Professor

Russian Federation, Ufa

Evgenii M. Gareev

Bashkir State Medical University

Email: gem46@list.ru
ORCID iD: 0000-0002-6561-0892

PhD (Biology), Associate Professor

Russian Federation, Ufa

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2. Fig. 1. Scar thickness before delivery in three groups: the abscissa axis shows the numbers of the groups: 1, one CS with metroplasty; 2, two CSs and metroplasty; 3, two CSs without metroplasty (control). On the ordinate axis, the scar thickness in mm.

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3. Fig. 2. Sequential changes in the scar thickness at different terms after CS in patients with one CS and metroplasty (group 1), with two CSs and metroplasty (group 2), and with two CSs without metroplasty (group 3, control). On the ordinate axis, scar thickness in mm.

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4. Fig. 3. Mean blood loss in the three groups: the abscissa axis shows the group numbers: 1, one CS with metroplasty; 2, two CSs and metroplasty; and 3, two CSs without metroplasty (control). The ordinate axis presents the blood loss in mm³. CI, confidence interval; SE, standard errors of mean values.

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