CESAREAN SECTION IN THE UNFORMED LOWER UTERINE SEGMENT

Objective. To determine the optimum technology for cesarean section in pregnant women with the unformed lower uterine segment. Subjects and methods. Eighty-eight puerperas were examined after cesarean section carried out in the presence of the unformed lower uterine segment. A transverse semilunar incision was made in 30 cases; an isthmic cervical incision was done using the Shmiden method and separate knotty sutures in 32; the modified Stark’s procedure applying a double-row suture was performed in 26, as described by Reverden. The nature of reparative processes at the site of the uterine incision was assessed from suture involution index, protein coefficient, and trends in the cytological pattern of uterine cavity aspirate. Results. The least good healing occurred after use of an isthmic cervical incision. The best healing was observed when the modified Stark’s procedure (a semilunar diagonal incision and Reverden suturing) was applied. This is indicated by the higher suture area evolution index and the time course of changes in cytological parameters and in the levels of immunoglobulins in the metroaspirate. Conclusion. The findings enable one to recommend this surgical technique in women with the unformed lower uterine segment.

cesarean section, unformed lower uterine segment, technology, reparative processes