Prognosis and perspectives of spontaneous delivery in women with uterine scar after cesarean section
AbstractPurpose. Define clinical and morphological criteria of scar after caesarean section to form the groups pregnant for the following vaginal labor.
Methodology. Рrospective study.
Setting. Federal State Budget Institution «Research Center for Obstetrics, Gynecology and Perinatology» Ministry of Healthcare of the Russian Federation, Scientific Research Institute Of Clinical and Experimental Lymphology, Siberian Branch of Russian Academy of Medical Sciences
Subjects. 66 laboratory animals (the rats to lines Vistar), 684 pregnant, which lay ahead the first operation of the caesarean section and 831 patients after preceding caesarean section.
Methods. Мorphometry and study of the condition microcirculation and cytogram of leukocyte in scar of the womb and border tissue; the ultrasonic study of scar after caesarean section and myometrium of intact uteri.
Results. Number and cytogram of leukocyte, as well as condition of hemocirculation and lymph drainage in scar on womb beside rats without the following labor and in scar on womb beside rats with spontaneous labor realistically did not differ.
The Single significant difference was concluded in expansion of compartment on border scar on womb beside animal after labor in contrast with that rat, beside which has occurred the spontaneous labor.
Thereby, in 2 months after labor were absent reliable change of hemocirculation and lymph drainage in layer myometrium and fabrics scar between intact rats, not given birth with scar on womb and given birth in condition of modeling scar miometrium From 381 pregnant after caesarean section, which planned birth through natural generic ways beside 183 (48 %) has occurred spontaneous labor. The repeated operation of the caesarean section is organized 198 woman (52 %). In structure of the evidences to emergency caesarean section beside woman with unceasing synthetic material only in 11,6 % events by reason onserved threatening breakup of the womb while under dual in-line catgut in 31,8 % full.
Conclusion. Тhe called on studies have shown the principle possibility and practicability of conduct sort beside patients with scar on womb after operation of the caesarean section through natural generic ways. At, the rally-blows to consider optimum recovering the lower segment of the womb unceasing synthetic seam.
Keywords:spontaneous delivery, uterine scar, cesarean section