Delivery in a pregnant woman with a bicornuate uterus and a scar after cesarean section

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Relevance: In the prenatal period, developmental abnormalities may occur under the influence of various exogenous and endogenous factors. Patients with a bicornuate uterus account for 0.4% of the total number of women, 1.1% of women with infertility and 2.1% of women who had a miscarriage. It is difficult to calculate the real prevalence of this abnormality of uterine development; however, the management of pregnancy and childbirth with a bicornuate uterus remains a relevant issue and challenge for doctors.

Case report: A 34-year-old patient, who had a previous history of childbirth by cesarean section due to a bicornuate uterus, was admitted to the obstetric department of the hospital. Due to the patient’s strong desire, doctors chose the tactics of vaginal delivery. The first stage of labor was uneventful, and a single dose of epidural analgesia was given. The second stage of labor was complicated by fetal distress, which led to the use of vacuum extraction of the fetus. A live full-term boy was delivered weighing 3030 g, 50 cm tall, with a score of 8 and 9 on the 1- and 5-minute by Apgar, respectively. During the entire period of labor, there were regular contractions of the uterus, lasting from 30 seconds in the first stage of labor to 1.5 minute in the active pushing phase of the second stage of labor.

Conclusion: It is possible for women with uterine malformations to give birth vaginally. It is necessary to study this abnormality, generalize and systematize the data in order to develop diagnostic algorithms and therapeutic approaches for the clinicians and their routine practice.

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Sobre autores

Tatyana Babich

Order of the Red Banner of Labor Medical Institute named after S.I. Georgievsky, V.I. Vernadsky Crimean Federal University; N.A. Semashko Republican Clinical Hospital, Perinatal Centre

Autor responsável pela correspondência
Email: 7047715@mail.ru
ORCID ID: 0000-0003-3274-0698

Dr. Med. Sci., Associate Professor, Professor of the Department of Obstetrics, Gynecology and Perinatology No. 1

Rússia, Simferopol; Simferopol

Anna Sulima

Order of the Red Banner of Labor Medical Institute named after S.I. Georgievsky, V.I. Vernadsky Crimean Federal University; Simferopol Clinical Maternity Hospital No. 1

Email: gsulima@yandex.ru
ORCID ID: 0000-0002-2671-6985

Dr. Med. Sci., Professor, Professor of the Department of Obstetrics, Gynecology and Perinatology No. 1

Rússia, Simferopol; Simferopol

Petr Baskakov

Order of the Red Banner of Labor Medical Institute named after S.I. Georgievsky, V.I. Vernadsky Crimean Federal University

Email: petr.baskakov@gmail.com
ORCID ID: 0000-0002-7382-7434

Dr. Med. Sci., Professor, Professor of the Department of Obstetrics, Gynecology and Perinatology No. 1

Rússia, Simferopol

Sabrie Suleymanova

City Hospital No. 9, Sevastopol

Email: sabrie97@mail.ru
ORCID ID: 0000-0002-9902-7726

Obsteterician-Gynecologist

Rússia, Sevastopol

Bibliografia

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2. Fig. 1. Echogram (2D mode)

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3. Fig. 2. Echogram (3D mode)

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4. Fig. 3. Fragment of the patient’s cardiotocogram showing regular contractions, lasting 60-90 s, of sufficient strength in the second stage of labor

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