A preliminary study of uterine scar tissue following cesarean section

Wu, Cailin; Chen, Xin; Mei, Zhixiong; Zhou, Juan; Wu, Liangzhi; Chiu, Wei-Hsiu; Xiao, Xiaomin

doi:10.1515/jpm-2016-0347

Cited by 26 publications

(18 citation statements)

References 23 publications

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“…Also in the group of patients with a scar (up to 3 years after surgery) the number of apoptotic nuclei was higher and significantly lower in the group that had CS 7-9 years before. The conclusion was that the uterine scar becomes mature at even 9 years after surgery [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Uterine rupture at 28 weeks of gestation after laparoscopic myomectomy – a case report

Tomczyk¹,

Wilczak²,

Rzymski³

2018

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There are many reasons for sterility, and uterine malformations are of the greatest concern. Among uterine disorders, myomas play a significant role and are present in 27% of infertile women. The occurrence of myomas is frequent – 20-40% in women of reproductive age. Thus, for those infertile patients surgical treatment may be needed to preserve an opportunity to conceive.This case report refers to an uterine rupture at 28 weeks of gestation after laparoscopic myomectomy (3 months before conceiving). The myomectomy was conducted correctly and two layers of sutures on the myometrium were performed.The purpose of the myomectomy in a young woman should be well considered. In cases of infertility, removal of the lesions is usually necessary to give the patient a chance of pregnancy. At the same time, the risk of uterine rupture is increased. There are some suggestions referring to myomectomy to reduce the risk of uterine rupture in a subsequent pregnancy. It seems that the method of sewing the uterine closure is crucial. For example, multilayer uterine stitches, preservation of the endometrial cavity, and avoidance of using electrosurgery to prevent devascularization (to avoid haematoma formation) should be taken into consideration to prevent weakness of the wall of the uterus. Uterine scars differ histologically and biochemically.

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Section: Discussionmentioning

confidence: 99%

Uterine rupture at 28 weeks of gestation after laparoscopic myomectomy – a case report

Tomczyk¹,

Wilczak²,

Rzymski³

2018

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“…In every third woman, signs of functional failure of the scar on the uterus are sonologically determined within a year after surgery [15]. It is believed that after surgery, the processes of repair in the myometrium normally flow due to the regeneration of smooth muscle cells (so-called morphological restitution).…”

Section: формування рубця на матці та експресія специфічних білків спmentioning

confidence: 99%

Uterine Scar Formation and Expression of Specific Connective Tissue Proteins

Zhelezov

Savenko²

2020

АПП

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The aim of the study – to evaluate the role of expression of specific connective tissue proteins in the formation of the scar on the uterus. Materials and Methods. The study was performed on the basis of the regional perinatal center and KU PB No. 5 during 2017–2019. 426 women with a scar on the uterus were examined, including 115 (27.0 %) with two or more scars. The mean age of the subjects was (33.4±1.1) years. The results of sonographic studies were analyzed. For pathomorphological examination, three cases of intranatal rupture of the uterine wall along the “old” scar after cesarean section from middle-aged women with a gestational age of 33 to 40 weeks are presented. The expression of collagen types 1 and 3 and the protein of the intermediate filaments of the muscle tissue of desmin was determined using a semi-quantitative method with the calculation of H-score. Results and Discussion. Analysis of ultrasound data showed that the average assessment of the degree of insolvency of the scar on the uterus was in the examined women X=(1.3±0.2) points, a high level of insolvency was found in 114 (26.8 %) pregnant women. At the same time, 225 (52.8 %) pregnant women showed no signs of scar failure at all. In 87 (20.4 %) one sign of uterine scar failure was found, in 76 (17.8 %) – two signs, in 20 (4.7 %) – three signs, and in 18 (4.2 %) – four signs. Subsequently, 44 (10.3 %) women were born operatively, the rest gave birth per via naturales. Local myometrial defect after ultrasound delivery was detected in 25 of 182 (13.7 %) women who gave birth independently. Conclusions. A high level of scar failure risk is found in 26.8 % of pregnant women. H-score valuesfor collagen types 1 and 3 averaged (212±24) and (188±22), for desmin – (193±17). Thus, reparative processes at the site of previous surgery on the uterine wall are by incomplete regeneration (substitution) and compensatory hyperplasia of structural tissue elements.

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“…Для пациентки N при выборе метода прерывания первой беременности следовало выбрать терапевтический метод (применение различных схем препаратов простогландинов, антипрогестагенов, окситоцина) [15][16][17][18]. Терапевтический метод следует рассматривать в первую очередь, так как травматизация миометрия в ходе операции приводит к нарушению его репарации и регенерации, создавая среду для размножения микроорганизмов [19]. Следует учитывать, что, согласно исследованиям [20], у женщин, в анамнезе которых было…”

Section: результаты и обсужденияunclassified

“Slow” Cesarean Section by Inconsistent Corporal Scar (Clinical Case)

Сафиуллин

Мусин

Molokanova

2018

Kreativnaâ hirurgiâ i onkologiâ

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Introduction. Increasing the initial number of caesarean delivery operations involves certain risks when planning and carrying subsequent pregnancies. Despite the trend towards operative childbirth being gradually being replaced by natural, the frequency of recurrent caesarean is higher than the prevailing rate due to scar inconsistency and the presence of a “classic” (corporal) scar on the uterus. The use of corporal access to date is gradually being replaced by less traumatic access. The operation of “slow” caesarean section is considered as an alternative approach to surgical delivery.Purpose and objectives. To analyse the operation of “slow” caesarean section in the presence of corporal scars on the uterus.Materials and methods. The resulted clinical case of incomplete rupture of the uterus by corporal scar in the second pregnancy at a period of 38 weeks. Corporal scarring as a result of caesarean operations in the case of interruption of first pregnancy at a period of 22–23 weeks.Results. The patient was discharged in a satisfactory condition on the 5th day with the child. Postoperative period without complications; results of analyses performed prior to discharge within normal limits.Discussion. The conducted corporal incision at the first pregnancy was inexpedient due to presenting increased risks in subsequent pregnancies. For the termination of pregnancy in the second trimester, it was necessary to consider therapeutic methods, the operations of a minor caesarean section or a caesarean section in the lower segment of the uterus.Conclusion. Conducting “slow” caesarean section has the following advantages over classic caesarean section: soft adaptation of the foetus to environmental conditions, purification of the mucous oropharynx of the foetus, establishing a stronger bond between the mother and her future child. In future, we plan to conduct a clinical evaluation of children delivered through a “slow” caesarean section.

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A preliminary study of uterine scar tissue following cesarean section

Abstract: The lower uterine segment scar becomes stable at 3 years after cesarean delivery, and by 9 years, the scar is mature.

Cited by 26 publications

References 23 publications

Uterine rupture at 28 weeks of gestation after laparoscopic myomectomy – a case report

Uterine rupture at 28 weeks of gestation after laparoscopic myomectomy – a case report

Uterine Scar Formation and Expression of Specific Connective Tissue Proteins

“Slow” Cesarean Section by Inconsistent Corporal Scar (Clinical Case)

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