scholarly journals OP30.08: Sonographic detection of uterine scar location following Cesarean section among pregnant women

2010 ◽  
Vol 36 (S1) ◽  
pp. 141-141
Author(s):  
O. Markovitch ◽  
R. Tepper ◽  
R. Hershkovitz
Author(s):  
V.N. Demidov, A.I. Gus, T.A. Yarygina

Our statistical analysis, based on ultrasound examination of 7069 pregnant women, showed that both in the absence and in the presence of a scar on the uterus in the region of its lower segment, the placenta in the 3rd trimester of pregnancy was located extremely rarely, only in 0.1%. It was either primarily located in other parts of the uterus, or migrated from the lower segment of the uterus towards the bottom. In the case of the location of the placenta in this area, its ingrowth was not observed only in 2.3% of women. The main ultrasound signs of ingrowth of the placenta into the scar was the absence of its migration, as well as the presence of a combination of placenta previa with its localization in the scar zone. From the data obtained, it follows that the sensitivity of ultrasound diagnosis of placental accreta was 97.7%, and the specificity was 99.9%. According to our data, ingrown placenta in most cases can be delivered as early as 14–19 weeks, and the time spent on detecting this pathology usually does not exceed one minute.


2015 ◽  
Vol 64 (2) ◽  
pp. 53-58 ◽  
Author(s):  
Vladislav Ivanovich Krasnopol’skiy ◽  
Lidiya Sergeevna Logutova ◽  
Svetlana Nikolaevna Buyanova ◽  
Marina Aleksandrovna Chechneva ◽  
Ketsvan Nodarievna Akhlediani

Cesarean section (CS) is the most widespread operation despite of high frequency of intra and post operational complications as opposed to spontaneous delivery. The aim of investigation (objective) is the analysis of outcomes of CS in every stages during and after CS. Material and methods. There is a retrospective analysis of 675 patients after CS. 60 women after pregnancy; 75 patients with insolvent scar after previous CS during planning of the next pregnancy; 540 scarred pregnant women in term and 24 pregnant women with implantation in the scar. Results. The application of the secondary sutures is indicated in the case of insufficient sutures on the uterine wall. The metroplastic operation is indicated during the next pregnancy. The insufficiency of the previous uterine scar is the indication for CS in more than 70 %. The earliest diagnosis of the localization of the placenta in the scar is desirable. The most cautious method of pregnancy interruption should be used with immediate or postponed metroplastic.


2020 ◽  
Vol 69 (1) ◽  
pp. 53-62
Author(s):  
Olga N. Nozhnitseva ◽  
Vitaliy F. Bezhenar

Hypothesis/aims of study. In the recent decades, the quality of uterine suture repair after a cesarean section is widely discussed, as local thinning of the myometrium forming uterine scar defects, or the so-called scar niche, are relatively common after the operation. The aim of this study was to identify the causes of local thinning of the uterine scar after cesarean section, to determine the effectiveness of existing methods for assessing the uterine scar in non-pregnant women, and to develop a method for surgical correction of this pathology. Study design, materials and methods. Over 4 years, 175 non-pregnant women with a uterine scar were examined. The 50 of them were diagnosed with the uterine scar niche, with a laparoscopic metroplasty performed in these patients. The effectiveness of the operation was evaluated in the long-term postoperative period. Results. Performing cesarean section because of weakness of labor activity and a complicated course of the postpartum period are significant factors in the formation of a uterine scar niche (p 0.05). Ultrasound examination and magnetic resonance imaging of the pelvic organs can be used to detect local thinning of the myometrium with a sensitivity of 82% and 96%, and a specificity of 85% and 90%, respectively. Conclusion. Metroplasty for patients with a diagnosed scar niche can significantly increase the thickness of the myometrium (p 0.05) and reduce the frequency of complaints of such menstrual irregularities as postmenstrual vaginal bleeding, dysmenorrhea, and hypermenorrhea (p 0.05).


2019 ◽  
Vol 12 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Saad Abdulrahman Hussain ◽  
Ulfat Mohammad Ali Al-Nakkash ◽  
Marwa Malik Anas ◽  
Alaa Ali Hussein ◽  
Faris Anwer Rasheed

2019 ◽  
Vol 6 (1) ◽  
pp. 38-42
Author(s):  
E. P Shevtsova ◽  
Anatoly E. Miroshnikov ◽  
Yu. A Shatilova ◽  
N. A Zharkin

Attempts of vaginal delivery in cases with a scar on the uterus after a previous cesarean section are more successful after appropriate psycho-prophylactic preparation during pregnancy. The purpose of the study is to reduce the frequency of repeated cesarean section operations. A comparison was made of the methods of delivery for pregnant women with a scar on the uterus after comprehensive training on an improved program and unprepared pregnant women. A total of 158 women were included in the study. Among them were those who had a cesarean section in history, but not trained for the current childbirth, only 5% gave birth independently. At the same time, women trained under the improved program had independent deliveries in 45.6% of cases (OR 5.813; 95% CI 0.826-40.885). The results confirm the effectiveness of the proposed improvements in the preparation of pregnant women with a scar on the uterus. The intention of such women to give birth through the natural birth canal, formed as a result of preparation, is an important factor for successfully overcoming the difficulties of the delivery process.


2016 ◽  
Vol 19 (5) ◽  
pp. E248-E254 ◽  
Author(s):  
Hasan Baki Altinsoy ◽  
Ozkan Alatas ◽  
Salih Colak ◽  
Hakan Atalay ◽  
Omer Faruk Dogan

Background: Cardiovascular complications that can cause severe catastrophic outcomes for both the mother and the fetus are rarely seen during pregnancy. Time to diagnosis is often delayed by a low degree of suspicion and atypical presentation. We report surgical strategies in three pregnant women with cardiovascular complications. Methods: A retrospective search from 2009 to 2016 identified three pregnant women who underwent urgent cardiac surgery. We used extracorporeal circulation (ECC) without cesarean section with careful follow-up of the fetuses during the perioperative and postoperative period. We used levosimendan as a potent inodilator in all patients to increase feto-placental blood flow and fetal heart rhythm.Results: Median time to diagnosis was 23.8 h (range 11.7-120 h) and median time from diagnosis to arrival in the operating theater was 9.8 h (range 7.4-19.8 h). One patient with prosthetic heart valve thrombosis underwent concomitant cesarean section prior to cardiac surgery. In a young pregnant woman who had spontaneous dissection of the left anterior descending artery, on-pump beating heart coronary artery bypass grafting was performed without cross clamping. Two and three months after surgery, cesarean sections were performed without any complication in two pregnant women.Conclusion: Because unusual cardiovascular complications are the main cause of maternal and/or fetus death during pregnancy, prompt and exact diagnosis is very important. Life-saving surgical strategy with the help of appropriate teams are necessary to optimize outcome for both mother and baby.


2020 ◽  
Vol 86 (4) ◽  
Author(s):  
Hideaki Ebana ◽  
Masahiro Murakawa ◽  
Yoshie Noji ◽  
Keisuke Yoshida ◽  
Jun Honda ◽  
...  

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