scholarly journals Results of operative obstetrical activity in modern obstetrics

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
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
High Frequency ◽  
Uterine Wall ◽  
Uterine Scar ◽  
Pregnancy Interruption ◽  
Spontaneous Delivery

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.

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.

Vaginal birth after cesarean (VBAC): fear it or dare it? An evaluation of potential risk factors

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Anastasia Lazarou ◽  
Magdalena Oestergaard ◽  
Johanna Netzl ◽  
Jan-Peter Siedentopf ◽  
Wolfgang Henrich
Keyword(s):  
Body Mass Index ◽  
Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Body Mass ◽  
Vaginal Birth ◽  
Vacuum Extraction ◽  
Vaginal Birth After Cesarean ◽  
Vaginal Deliveries ◽  
Spontaneous Delivery

Abstract Objectives The consultation of women aspiring a vaginal birth after caesarean may be improved by integrating the individual evaluation of factors that predict their chance of success. Retrospective analysis of correlating factors for all trials of labor after caesarean that were conducted at the Department of Obstetrics of Charité-Universitätsmedizin Berlin, Campus Virchow Clinic from 2014 to October 2017. Methods Of 2,151 pregnant women with previous caesarean, 408 (19%) attempted a vaginal birth after cesarean. A total of 348 women could be included in the evaluation of factors, 60 pregnant women were excluded because they had obstetric factors (for example preterm birth, intrauterine fetal death) that required a different management. Results Spontaneous delivery occurred in 180 (51.7%) women and 64 (18.4%) had a vacuum extraction. 104 (29.9%) of the women had a repeated caesarean delivery. The three groups showed significant differences in body mass index, the number of prior vaginal deliveries and the child’s birth weight at cesarean section. The indication for the previous cesarean section also represents a significant influencing factor. Other factors such as maternal age, gestational age, sex, birth weight and the head circumference of the child at trial of labor after caesarean showed no significant influence. Conclusions The clear majority (70.1%) of trials of labor after caesarean resulted in vaginal delivery. High body mass index, no previous spontaneous delivery, and fetal distress as a cesarean indication correlated negatively with a successful vaginal birth after cesarean. These factors should be used for the consultation of pregnant women.

scholarly journals CERVICAL INSUFFICIENCY: ANAMNESIS, PREGNANCY AND CONSEQUENCES OF PREGNANCY (RETROSPECTIVE ANALYSIS)

2021 ◽  
pp. 30-38
Author(s):  
A. V. KAMINSKYI ◽  
O. I. ZHDANOVYCH ◽  
T. V. KOLOMIICHENKO ◽  
R. I. ISMAILOV ◽  
S. M. YANUTA
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
High Frequency ◽  
Premature Birth ◽  
Uterine Cavity ◽  
Lower Percentage ◽  
Control Group ◽  
Cervical Canal ◽  
Cervical Insufficiency

Cervical insufficiency (CI) remains one of the leading causes of miscarriage and premature birth. Purpose of the study: to determine the frequency of CI, the characteristics of the anamnesis, the course of pregnancy, childbirth, the state of the newborn and the identification of potential risk factors. Material and research methods. 8728 birth histories were analyzed, among which 166 (1.9%) stories of women whose pregnancy was complicated by CI were found. The main group consisted of 166 pregnant women with CI, the control group included 55 women without CI and other severe obstetric- gynecological and somatic pathologies. The results obtained and their discussion. The incidence of CI on average over 5 years was 1.9%. With CI, there is a significantly lower percentage of young women, and at the age of 35 and over - 27.1% of pregnant women versus 10.9% in the control group. Only one third (33.7%) of women with CI can be considered somatically healthy. The morbidity structure is dominated by endocrine pathology (30.7%), among which metabolic syndrome / obesity (19.9%) and diseases of the urinary excretory system (27.7%) are distinguished. High frequency of pathology of the cardiovascular system (21.1%) and autonomic dysfunction syndrome (25.9%), hepatobiliary pathology (15.1%), gastrointestinal diseases (19.3), allergic manifestations (16.9%). A third of patients (28.9%) have a combination of two or more somatic diseases. Every fourth woman has a history of an infectious pathology of the urinary excretory sphere (25.9). In 27.7% of patients - a combination of several infectious pathologies. Half of the patients (53.0%) had a complicated gynecological history: cervical ectopy (33.7%), chronic infectious diseases of the genital area (16.3%) and PCOS: (13.9%), synechiae of the uterine cavity (6.6 %) and congenital malformations of the genitals (3.0%). The combination of several gynecological pathologies was observed in 18.1% of women. Every fourth woman underwent an excision of the cervix (25.9%), 42.8% - intrauterine interventions with the expansion of the cervical canal, 59.2% of them two or more times. According to the obstetric anamnesis, spontaneous miscarriages and medical abortions in 27.7% and 33.7% of women, in 18.1% - a missed pregnancy, every fourth patient has premature birth (25.9%), and every 10th patient has suffered injuries cervix. With a current pregnancy, the threat of premature birth is most often noted (51.2%), in second place is an exacerbation of infection of the genitourinary sphere (41.0%) and the threat of premature birth (38.0%). High incidence of placental dysfunction (30.7%), gestational diabetes (13.9%), fetal growth retardation (12.0%) and preeclampsia (7.3%). Premature birth in 38.0% of cases, in 31.9% - premature rupture of membranes, delivery by cesarean section in 19.3% of cases. Noteworthy is the high frequency of intrauterine infection (13.9%). Conclusion. Based on the results of a retrospective analysis, after a more detailed assessment of possible risk factors for CI, the most informative ones will be identified and proposed for use in clinical practice.

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).

scholarly journals UTERINE SCAR FORMATION AND EXPRESSION OF SPECIFIC CONNECTIVE TISSUE PROTEINS

2020 ◽  
pp. 132-136
Author(s):  
D. M. Zhelezov ◽  
T. O. Savenko
Keyword(s):  
Connective Tissue ◽  
Pregnant Women ◽  
Uterine Wall ◽  
Collagen Types ◽  
Previous Surgery ◽  
Perinatal Center ◽  
The Mean ◽  
Uterine Scar ◽  
High Level

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.

The course of pregnancy, delivery and the condition of newborn in women with uterus scar after previous cesar section

2020 ◽  
pp. 42-46
Author(s):  
N. Kovyda ◽  
◽  
N. Honcharuk ◽  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
Vaginal Delivery ◽  
Early Pregnancy ◽  
Previous Cesarean Section ◽  
Pregnancy And Childbirth ◽  
Birth Record ◽  
History Of ◽  
Previous Cesarean

The objective: Analysis of pregnancy, delivery and the condition of newborns in women with uterus scar after previous Cesarean section. Materials and methods. Observations and retrospective analysis of individual maps of pregnant women, birth record and condition of newborns in 180 women with uterus scar after previous Cesarean section from 2014-2019. Results. It was found that women in I group had no history of miscarriage, and in II group this indicator was 6.7%. We were determined that the threat of early pregnancy was observed twice often in II group as in I group. Failure uterus scar during pregnancy was diagnosing in 21.1% of women of I group against 18.9% of women of II group, as well as during childbirth in 10% of women of II group against none of women of I group. In addition, 76.7% of women of I group were born by vaginal delivery against 24.4% of women of II group. In addition, 10% of newborns in women of I group on the Apgar scale were rated 6-7 points against 65.5% in a state of varying degrees of hypoxia in women of II group. Conclusion. Pregnancy and childbirth in women with uterus scar after previous Cesarean section were accompanying by complications of fetal and neonatal disorders. More pronounced changes were observing during pregnancy, delivery and changes in the condition of newborns in women of II group against with women of I group, which can be explaining by better pre-pregnancy preparation of women of I group and better monitoring during pregnancy. Keywords: сesarean section, pre-pregnancy preparation of women, the condition of newborns.

COVID 19 INFECTION AS A RISK FACTOR FOR PREMATURE DETACHMENT OF THE NORMALLY LOCATED PLACENTA

2021 ◽  
pp. 77-81
Author(s):  
D.A. Nikitin ◽  
◽  
V.S. Verbitski ◽  
L.N. Vasileva ◽  
M.S. Verbitskaya ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
Premature Birth ◽  
Maternity Hospital ◽  
Medical Institution ◽  
Control Group ◽  
Clinical Hospital ◽  
In Pregnancy

A retrospective analysis of childbirth was carried out in 298 women with confirmed COVID-19 infection (main group) who received treatment in the maternity hospital of the 6th City Clinical Hospital of Minsk in the period from April 14, 2020 to February 14, 2021. The control group included pregnant women who gave birth during 2017—2019 in this medical institution (total 12 812). There was an increase in the incidence of premature birth from 2.7 % in pregnant women in the control group to 5.7 % in patients with COVID-19. The pathology in pregnancy significantly increased the frequency of cesarean section — 45.6 % in patients with COVID -19 Women with COVID-19 infection significantly more often have such a severe complication as premature abruption of normally located placenta (P < 0.05).

Sign in / Sign up

Export Citation Format

Share Document