The possibility of high-precision ultrasound diagnosis of placenta ingrowth into the uterine scar after cesarean section

2020 ◽  
Author(s):  
V.N. Demidov, A.I. Gus, T.A. Yarygina
Keyword(s):  
Statistical Analysis ◽  
Cesarean Section ◽  
Pregnant Women ◽  
High Precision ◽  
Ultrasound Examination ◽  
Placenta Previa ◽  
Ultrasound Diagnosis ◽  
Lower Segment ◽  
Uterine Scar

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.

scholarly journals The niche in the uterine cesarean scar: a new problem of women’s reproductive health

2020 ◽  
Vol 69 (1) ◽  
pp. 53-62
Author(s):  
Olga N. Nozhnitseva ◽  
Vitaliy F. Bezhenar
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Ultrasound Examination ◽  
Suture Repair ◽  
Resonance Imaging ◽  
Complicated Course ◽  
Uterine Scar ◽  
Significant Factors

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).

Ultrasound diagnosis conditions of the uterus scar in pregnant and non-pregnant women

2020 ◽  
pp. 39-43
Author(s):  
N. Kovyda ◽  
◽  
N. Honcharuk ◽  
Keyword(s):  
Blood Flow ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Vascular Resistance ◽  
Ultrasound Examination ◽  
Ultrasound Diagnosis ◽  
Control Group ◽  
Previous Cesarean Section ◽  
Uterine Arteries ◽  
Previous Cesarean

The dynamic increase in the number of caesarean section in Ukraine and around the world remains one of the main topics of discussion, which is intensively discussing by leading scientists. The traditional assessment of the ability of the uterus scar during pregnancy, based mainly on the analysis of clinical and anamnestic data, is not high informative, and the ambiguous conclusions of the sonographic study indicate the need for further detailed study. Therefore, there is reason to believe that the development of criteria for ultrasound assessment of the condition of the uterus scar after previous cesarean section will use them to predict the possibility of spontaneous delivery in the future and remains relevant. The objective: study the features of ultrasound diagnosis of the condition of the scar on the uterus in pregnant and non-pregnant women. Materials and methods. Observations and retrospective analysis of medical records of pregnant women and birth histories in 150 women with a scar on the uterus after a previous cesarean section for the period from 2014–2019. Results. In women who became pregnant up to a year after the previous cesarean section, the most pronounced changes in blood flow were in the uterine arteries, especially during gestation 28–34 weeks. Also, in women with a failed uterus scar, changes in blood flow were most often observed in the uterine arteries at all levels and were significantly higher, compared with women with a capable uterus scar and women from the control group. In women with an insolvent uterus scar, the most pronounced changes in the indices of vascular resistance was observed in the uterine arteries, in particular the right uterine artery. Conclusion. The peculiarities of blood flow and vascular resistance in different vessels of the myometrium depending on the gestation period and the timing of pregnancy after a previous cesarean section. The obtained detailed ultrasound examination and mathematical calculation of the results of ultrasound examination of the uterus and postoperative uterus scar after previous cesarean section in non-pregnant women allowed to create a scale for assessing the condition of the uterus scar after previous cesarean section in non-pregnant women. Keywords: cesarean section, uterus scar, ultrasound, pre-pregnancy preparation of women.

Placenta previa and increta into the lower segment myometrium and cervical canal with uterine artery aneurysm in pregnant women with no uterine scar

2019 ◽  
Vol 5_2019 ◽  
pp. 194-199
Author(s):  
Tskhai V.B. Tskhai ◽  
Glyzina Yu.N. Glyzina ◽  
Yametov P.K. Yametov ◽  
Levanova E.A. Levanova ◽  
Lobanova T.T. Lobanova ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Uterine Artery ◽  
Placenta Previa ◽  
Artery Aneurysm ◽  
Cervical Canal ◽  
Lower Segment ◽  
Uterine Scar

scholarly journals Retrospective Evaluation of Anesthetic Management in Cesarean Sections of Pregnant Women with Placental Anomaly

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Aykut Urfalıoglu ◽  
Gözen Öksüz ◽  
Bora Bilal ◽  
Seyma Teksen ◽  
Feyza Calışır ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Placenta Previa ◽  
Anesthetic Management ◽  
Fresh Frozen Plasma ◽  
University Hospital ◽  
Mechanical Ventilation Duration ◽  
Intraoperative Management ◽  
Fresh Frozen ◽  
Group A

Background. In this study, patients who underwent cesarean section and had placenta previa and placenta accreta were examined and compared in terms of haemorrhagic indicators and perioperative anesthetic management. Methods. A retrospective study was conducted in a university hospital in Kahramanmaras, Turkey. It included 95 pregnant women who had placental anomaly and underwent cesarean section between December 15, 2014, and February 15, 2016. Results. The pregnant women were divided into two groups: Group P (previa) (n = 67) and Group A (accreta) (n = 28). The types of anesthesia administered were general anesthesia (GA), which was administered to 50 patients (74.6%) in Group P and 27 patients (96.4%) in Group A, and spinal anesthesia (SA), which was administered to 17 patients (25.4%) in Group P and one patient (3.6%) in Group A.. The mean blood loss was 685.82 ± 262.82 in Group P and 1582.14 ± 790.71 in Group A, and the given amount of crystalloid was higher in Group A with an average of 1628.57 ± 728.19 ml. The use of erythrocyte and fresh frozen plasma solution was higher in Group A than Group P. Eleven patients were intubated and taken to the Intensive Care Unit (ICU) in Group A. Postoperative mechanical ventilation duration was significantly higher in Group A (75.14 ± 43.84 h) (p<0.001). ICU stay was longer in Group A with 2.80 ± 1.13 days. (p<0.001). Conclusion. The intraoperative management and the availability of postoperative ICU conditions are important in placental anomalies cases. The communication between operation team with regard to the development of a standard protocol for these cases will be of great benefit in reducing morbidity and mortality.

scholarly journals Perinatal risks at the repeated caesarean section and vaginal delivery in women with a uterine scar

2014 ◽  
Vol 18 (2 (70)) ◽  
Author(s):  
O. V. Kravchenko ◽  
V. A. Varvus
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Genital Tract ◽  
Vaginal Birth ◽  
Perinatal Complications ◽  
Lower Segment ◽  
Perinatal Pathology ◽  
Uterine Scar ◽  
Perinatal Risks ◽  
In Pregnancy

251 pregnant women were under observation with a uterine scar after previously performed cesarean section. 225 women were operated one more time. 26 women had delivery through natural genital tract (10 % of the pregnant women with a uterine scare). It was established that the delivery occurred physiologically due to the correct assessment of risk factors for vaginal birth in women with a uterine scar. The presence of uterine scar in the lower segment does not significantly affect the nature and duration of labor. An increased fetal weight at vaginal birth in women with a uterine scar to 300g does not increase obstetric and perinatal complications. Thus, the study has shown that an increase of complications such as placentation in the scar and scar failure is high risk of maternal and perinatal pathology in pregnancy with a uterine scar.

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