Estimated efficiency of uterine cavity suturing in patients during organ-preserving surgery with placenta increta while examining reproductive function in the postpartum period

Abstract

Aim: to study the reproductive function of patients who underwent organ-preserving delivery using a modified method of suturing the uterine cavity with ingrowth of the placenta.Materials and methods. The studied groups were comparable. The ultrasound assessment of the size of the uterus when comparing subgroups A and B, showed a significantly less severity of postoperative changes in the uterine cavity and the shape of the uterus. Retrospectively analyzed 77 cases of planned delivery of patients in 2018–2020. Group 1 (control) – 32 patients with a scar on the uterus after a previous cesarean section and group 2 (main) – 45 patients with a diagnosis of placental ingrowth which was divided into 2 subgroups – 2A (n = 23) where a modified method of suturing the uterine cavity was used, and subgroup 2B (n = 22) where a linear method was used.Results. The studied groups were comparable. After 6 months, we check the changes in the size of the uterus was revealed in comparison with the control group, statistical differences were observed in the 2A subgroup compared to the control (p < 0,05 in width and length of the uterus) and in subgroup 2B (also p < 0.05 for all indicators). The study of intrauterine blood flow did not reveal significant differences between the compared groups (p > 0.1), and ultrasound assessment of the size of the uterus when comparing subgroups A and B, showed a significantly less severity of postoperative changes in the uterine cavity and the shape of the uterus.Conclusion. Evaluation of a new method of suturing the uterine cavity in patients with placental ingrowth has shown significant efficiency in maintaining the anatomically most natural shape of the uterus and uterine cavity. Despite the results obtained, the problem of restoring the reproductive function of women who underwent organ-preserving delivery remains relevant and requires further study.