Clinicopathological features of gestation course associated with uterine scar dehiscence in women with a past medical history of a single caesarean section
https://doi.org/10.23946/2500-0764-2023-8-3-37-43
Abstract
Aim. To compare the clinicopathological features, the course of pregnancy and its outcomes with the results of histological examination of the uterine scar in women with a past medical history of a single caesarean section.
Materials and Methods. We analysed the associations between histological features of scarred myometrium and clinicopathological parameters of 48 pregnant women aged 19 to 40 years with a past medical history of a single caesarean section. All women were divided into two groups depending on the uterine scar condition. Tissue sampling for histological examination was performed during lower segment caesarean section from the scar area after fetal extraction.
Results. 26 women had non-defective uterine scar and 22 women had uterine scar dehiscence (an overstretched inferior uterine segment with little or no muscle fiber and disorganised connective tissue at histological examination). Clinicopathological parameters associated with a uterine scar dehiscence were are ≤ 2-year interval between deliveries (OR = 6.85, 95% CI = 1.27-36.90, p = 0.025) and obesity (OR = 3.5, 95% CI = 0.97-12.70, p = 0.056). Typical pregnancy complication in patients with uterine scar dehiscence was placental insufficiency (OR = 4.75, 95% CI = 1.39-16.2, p = 0.013).
Conclusion. Identification of the risk factors for uterine scar dehiscence may assist in selecting a method of delivery for women with a past medical history of caesarean section.
About the Authors
M. B. Igitova
Altai State Medical University
Russian Federation
Russian Federation
Marina B. Igitova - MD, DSc, Professor, Altai State Medical University.
40, Kirova Street, Barnaul, 656038
K. V. Dmitrienko
Altai State Medical University
Russian Federation
Russian Federation
Ksenia V. Dmitrienko - MD, PhD, Assistant Professor, Department of Obstetrics and Gynecology, Altai State Medical University.
40, Kirova Street, Barnaul, 656038
V. A. Borovkov
Altai Regional Clinical Center for Maternity and Childhood Care (Perinatal Center)
Russian Federation
Russian Federation
Vladimir A. Borovkov - MD, PhD, Deputy Chief Physician for Obstetrics and Gynecology, Altai Regional Clinical Center for Maternal and Child Health.
179, Gushchina Street, Barnaul, 659019
Yu. N. Nesterov
Altai Regional Clinical Center for Maternity and Childhood Care (Perinatal Center)
Russian Federation
Russian Federation
Yuri N. Nesterov - MD, Head of the Pathology Unit, Altai Regional Clinical Center for Maternal and Child Health.
179, Gushchina Street, Barnaul, 659019
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Review
For citations:
Igitova M.B., Dmitrienko K.V., Borovkov V.A., Nesterov Yu.N. Clinicopathological features of gestation course associated with uterine scar dehiscence in women with a past medical history of a single caesarean section. Fundamental and Clinical Medicine. 2023;8(3):37-43. (In Russ.) https://doi.org/10.23946/2500-0764-2023-8-3-37-43
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