Ultrasound assessment of uterine scar competence during labor
- Authors: Kuznetsova N.B.1,2, Ilyasova G.M.1, Bushtyreva I.O.2, Todorov S.S.1, Barinova V.V.1,2
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Affiliations:
- Rostov State Medical University, Ministry of Health of the Russian Federation
- Professor Bushtyreva Clinic LLC
- Issue: No 6 (2022)
- Pages: 114-121
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/249576
- DOI: https://doi.org/10.18565/aig.2022.6.114-121
- ID: 249576
Cite item
Open Access
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Abstract
Background: Fear of vaginal delivery is most commonly associated with uterine rupture in women with postcesarean uterine scar. The fact that the morphological competence of the scar and its ability to dehisce at the onset of labor cannot be prognostically evaluated necessitates the exchange of experience in managing vaginal delivery with uterine scar. Materials and methods: A prospective study of 41 pregnant women with a uterine scar after a single cesarean section was conducted. All the women were scheduled for vaginal delivery. Uterine scar competence was assessed clinically and ultrasonographically at the onset of labor. Results: Twenty-six women delivered vaginally; 15 were re-operated. The indications for repeat cesarean section were labor abnormalities (n=7), clinically narrow pelvis (n=4), and threat of uterine scar incompetence (n=4). Intraoperatively, the uterine scar was competent in 11 patients; there was scar incompetence, incomplete uterine rupture, and uterine scar dehiscence in 4, 2, and 2 patients, respectively. Conclusion: The causes of unsuccessful attempts at vaginal delivery after caesarean section are not always associated with scar incompetence. The scars most commonly turn out to be intraoperatively competent. It is advisable to ultrasonographically assess scar competence at the onset of labor in women planning vaginal delivery.
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About the authors
Natalya B. Kuznetsova
Rostov State Medical University, Ministry of Health of the Russian Federation; Professor Bushtyreva Clinic LLC
Email: lauranb@inbox.ru
Dr. Med. Sci., Professor at the Center for Simulation Training
Gulmira M. Ilyasova
Rostov State Medical University, Ministry of Health of the Russian Federation
Email: gulmirka666@mail.ru
post-graduate student
Irina O. Bushtyreva
Professor Bushtyreva Clinic LLC
Email: kio4@mail.ru
Dr. Med. Sci., Professor, Director
Sergey S. Todorov
Rostov State Medical University, Ministry of Health of the Russian Federation
Email: sertodorov@gmail.com
Dr. Med. Sci., Associate Professor, Head of the Department Pathological Anatomy, Head of the Morphological Department of the Clinic
Viktoriya V. Barinova
Rostov State Medical University, Ministry of Health of the Russian Federation; Professor Bushtyreva Clinic LLC
Email: victoria-barinova@yandex.ru
PhD, Assistant Professor at the Department of Obstetrics and Gynecology No. l
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