Pregnancy prolongation during uterine scar dehiscence after caesarean section
- Authors: Savina L.V.1,2, Yashchuk A.G.2, Gurova Z.G.1,2, Arkhipov V.V.1, Savin A.M.1, Maslennikov A.V.2
-
Affiliations:
- Maternity Hospital No. 3, Ufa
- Bashkir State Medical University, Ministry of Health of the Russian Federation
- Issue: No 3 (2022)
- Pages: 148-154
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/274679
- DOI: https://doi.org/10.18565/aig.2022.3.148-154
- ID: 274679
Cite item
Open Access
Access granted
Abstract
Background: The incidence of uterine scar dehiscence amounts to about 0.2-4.5% and carries the risks of transition to uterine rupture. The data on the frequency of ruptures are different, which is associated with the inaccuracy of the terminology, with the fact what is included in the concept of “uterine scar rupture” and “scar dehiscence”. This necessitates a search for new approaches to managing patients with this complication, including innovative ones that allow not only to preserve the uterus, but also to prolong pregnancy in order to improve perinatal outcomes. Case report: The paper presents experience in managing patients with uterine scar dehiscence after cesarean section in the second trimester of pregnancy with the clinical presentations of incomplete (non-penetrating) uterine scar rupture. In all three described cases, metroplasty followed by pregnancy prolongation could be performed. Conclusion: Metroplasty during the current pregnancy could prolong pregnancies that ended in the birth of viable babies.
Keywords
Full Text
About the authors
Liana V. Savina
Maternity Hospital No. 3, Ufa; Bashkir State Medical University, Ministry of Health of the Russian Federation
Email: anika-cor@mah.ru
postgraduate student of the Department of Obstetrics and Gynecology; Deputy Chief Medical Officer
Alfiya G. Yashchuk
Bashkir State Medical University, Ministry of Health of the Russian FederationDr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology
Zukhra G. Gurova
Maternity Hospital No. 3, Ufa; Bashkir State Medical University, Ministry of Health of the Russian FederationPhD, Associate Professor at the Department of Obstetrics and Gynecology; Chief Physician
Vladimir V. Arkhipov
Maternity Hospital No. 3, UfaPhD, obstetrician-gynecologist, Department of Obstetrics
Albert M. Savin
Maternity Hospital No. 3, Ufaobstetrician-gynecologist, Head of the Maternity Department
Anton V. Maslennikov
Bashkir State Medical University, Ministry of Health of the Russian FederationPhD, Associate Professor at the Department of Obstetrics and Gynecology, Associate Professor at the Department of Anatomy
References
- Айламазян Э.К., Кулаков В.И., Радзинский В.Е., Савельева Г.М., ред. Акушерство. Национальное руководство. М.: ГЭОТАР-Медиа; 2014. 1200с.
- Кулаков В.И., Манухин И.Б., Савельева Г.М., ред. Гинекология. Национальное руководство. М.: ГЭОТАР-Медиа; 2007. 1072с.
- Кулаков В.И., Чернуха Е.А., Комиссарова Л.М. Кесарево сечение. М.: Триада-Х; 2004. 160с.
- Chilaka V.N., Cole M.Y., Habayeb O.X., Konje J.C. Risk of uterine rupture following induction of labour in women with a previous caesarean section in a large UK teaching hospital. J. Obstet. Gynaecol. 2004; 24(3): 264-5. https://dx.doi.org/10.1080/01443610410001660751.
- Шмидт А.А., Тимофеева Н.Б., Соломко Д.В., Гайворонских Д.И., Егорова А.А. Пролонгированные беременности у женщины с разрывом матки по рубцу. StatusPraesens. 2019: 1: 111-3.
- Сафиуллин Р.И., Мусин И.И., Молоканова А.Р. «Медленное» кесарево сечение при несостоятельности корпорального рубца (клинический случай). Креативная хирургия и онкология. 2018; 8(2): 159-64.
- Логутова Л.С., Гаспарян Н.Д., Ахвледиани К.Н. Критерии диагностики состояния рубца на матке после кесарева сечения. В. кн.: IV Российский форум «Мать и Дитя»: Тезисы докладов. М.; 2017: 376-7.
- Savukyne E., Bykovaite-Stankeviciene R., Machtejeviene E., Nadisauskiene R., Maciuleviciene R. Symptomatic uterine rupture: a fifteen year review. Medicina (Kaunas). 2020; 56(11): 574. https://dx.doi.org/10.3390/medicina56110574.
- Sanchez-Ramos L., Kaunitz A.M., Peterson H.B., Martinez-Schnell B., Thompson R.J. Reducing cesarean section rates at a teaching hospital. Am. J. Obstet. Gynecol. 1990; 163(3): 1081-7; discussion 1087-8. https://dx.doi.org/10.1016/0002-9378(90)91132-v.
- Ibrahim S., Drymiotou S., Hegab K., Sideris M., Okba M. Second trimester rupture uterus, unusual presentation. Ann. Med. Surg. (Lond.). 2020; 61: 145-7. https://dx.doi.org/10.1016/j.amsu.2020.12.020.
- Стрижаков А.Н., Кузьмина Т.Е. Беременность после кесарева сечения: течение, осложнения, исходы. Вопросы гинекологии, акушерства и перинатологии. 2017; 1(2): 40-6.
- You S.H., Chang Y.L., Yen C.F. Rupture of the scarred and unscarred gravid uterus: outcomes and risk factors analysis. Taiwan. J. Obstet. Gynecol. 2018; 57(2): 248-54. https://dx.doi.org/10.1016/j.tjog.2018.02.014.
- Wing D.A., Paul R.H. Vaginal birth after cesarean section: selection and management. Clin. Obstet. Gynecol. 1999; 42(4): 836-48. https://dx.doi.org/10.1097/00003081-199912000-00010.
- Abdelazim I.A., Shikanova S., Kanshaiym S., Karimova B., Sarsembayev M., Starchenko T. Cesarean section scar dehiscence during pregnancy: Case reports. J. Family Med. Prim. Care. 2018; 7(6): 1561-5. https://dx.doi.org/10.4103/jfmpc.jfmpc_361_18.
- Sawada M., Matsuzaki S., Nakae R., Iwamiya T., Kakigano A., Kumasawa K. et al. Treatment and repair of uterine scar dehiscence during cesarean section. Clin. Case Rep. 2017; 5(2): 145-9. https://dx.doi.org/10.1002/ccr3.766.
- Савельева Г.М., Курцер М.А., Бреслав И.Ю., Караганова Е.Я., Неклюдова Ю.В. Непроникающий разрыв матки по рубцу после кесарева сечения и расползание/аневризма рубца на матке во второй половине беременности и в родах. Акушерство и гинекология. 2021; 6: 66-72. [Savelyeva G.M., Kurtser M.A., Breslav I. Yu. Karaganova E.Ya, Neklyudova Yu.V. Non-penetrating uterine rupture along the scar after cesarean section and dehiscence /aneurysm of the uterine scar in the second half of pregnancy and during childbirth. Obstetrics and Gynecology. 2021; 6: 60-72 (in Russian)]. https://dx.doi.org/10.18565/aig.2021.6.66-72.
- Жаркин Н.А., Баринов С.В., Логутова Л.С., Биндюк А.В., Мирошников А.Е., Шевцова Е.П., Семихова Т.Г. Беременность и роды у женщин с оперированной маткой: монография. М.; 2020. 102с.
- Жаркин Н.А., Прохватилов С.А., Бурова Н.А., Гаврильчук Т.К., Грамматикова О.А., Мудрая Е.В., Снигур Г.Л. Хирургическая реконструкция рубца на матке во время беременности. Показания, условия и риски. Акушерство и гинекология. 2018; 10: 142-7. [Zharkin N.A., Prokhvatilov S.A., Burova N.A., Gavrilchuk T.K., Grammatikova O.A., Mudraya E.V., Snigur G.L. Surgical repair of uterine scar during pregnancy: indication, conditions, and riskc. Obstetrics and Gynecology. 2018; 10: 142-7. (in Russian)]. https://dx.doi.org/10.18565/aig.2018.10.142-147.
Supplementary files
