Chronic endometritis and an incompetent uterine scar after cesarean section: long-term outcomes of metroplasty


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Objective. To determine the impact of chronic endometritis (CE) on the formation of an incompetent uterine scar (IUS) and the results of laparoscopic metroplasty. Subjects and methods. The investigation included 50 patients with IUS in the periods longer than 1 year after cesarean section. Laparoscopic metroplasty was performed in conjunction with preparatory and rehabilitation activities. The outcomes were compared between two groups: 1) 26 patients with CE and 2) 24patients without CE. Results. The rate of CE in patients with IUS was 52%. The overall efficiency of laparoscopic metroplasty was 92%. The outcomes were the same in patients with and without CE: the onset of pregnancy was 60 and 81%, respectively (p = 0.22), birth was in 60 and 64.7% (p = 0.21), the progression of pregnancy was in 20 and 12.5% (p = 0.35). Conclusion. The high rate (52%) of CE suggests that the latter has a possible role in the pathogenesis of IUS. Laparoscopic metroplasty in combination with preparation and rehabilitation is effective in 92%.

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作者简介

Evgeniy Glukhov

Ural State Medical University of the Ministry of Health of Russia; Center for Operative Gynecology «Women's Clinic»

Email: 9222241411@mail.ru
MD, professor of the Department of Obstetrics and Gynecology; Chief physician

Galina Dikke

Private Educational Institution «Academy of Medical Education named F.I. Inozemtsev»

Email: galadikke@yandex.ru
MD, associate professor, professor of the Department of Obstetrics and Gynecology with a course of reproductive medicine

Ekaterina Neff

Center for Operative Gynecology «Women's Clinic»

Email: neff1974@mail.ru
associate professor of medical sciences, Deputy Chief Physician

Viktoria Glukhova

Ural State Medical University, Ministry of Health of Russia

Email: gluhovav17@mail.ru
student

Anna Svyazhina

Ural State Medical University of the Ministry of Health of Russia

Email: chizgik@yandex.ru
student

参考

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  4. Tower A.M., Frishman G.N. Cesarean scar defects: an underrecognized cause of abnormal uterine bleeding and other gynecologic complications. J. Minim. Invasive Gynecol. 2013; 20(5): 562-72. doi: 10.1016/J.JMIG.2013.03.008.
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