MODERN DIAGNOSTIC CAPABILITIES FOR UTERINE SCAR INTEGRITY
DOI:
https://doi.org/10.17605/Abstract
One of the important tasks of obstetrics is to reduce maternal and perinatal mortality. Over the past 30 years, there has been a clear trend towards a significant increase in the frequency of CS in order to reduce perinatal losses [1]. Every year, 1.5 million CS are performed worldwide [2]. It should be noted that due to the expansion of indications for CS, the number of women of childbearing age with postoperative RUI is steadily increasing [3]. Incomplete healing of RUI has become one of the recognized complications associated with this type of surgery. The exact cause and mechanism of the occurrence of the so-called niche - a deepening of the myometrium on the endometrial side of at least 2 mm - are still not entirely clear [4]. In recent decades, many researchers have proposed the use of various other terms to denote the phenomenon of local thinning of the scar area, calling this condition a diverticulum, a sac, a scar leak, a scar dehiscence, an isthmocele, etc. [8-10]. Keywords: uterine scar, cesarean section, scar integrity, diagnosis, incompetent scar.
References
1. Роды одноплодные, родоразрешение путём кесарева сечения: Федеральные клинические рекомендации по ведению больных. Москва, 2021.
2. Antoine C., Young B.K. Cesarean section one hundred years 2020: the good, the bad and the ugly // J Perinat Med. 2021. Vol. 49, N 1. P. 5–16.
3. Antila-Långsjö R.M., Mäenpää J.U., Huhtala H.S., et al. Cesarean scar defect: a prospective study on risk factors // Am J Obstet Gynecol. 2018. Vol. 219, N 5. P. 458.e1–458.e8.
4. Akdaş Reis Y., Varli E.N., Özkan S., et al. Importance of hemogram parameters for predicting uterine scar dehiscence // J Turk Ger Gynecol Assoc. 2024. Vol. 25, N 1. P. 38–43.
5. Sun Q., Tang L., Zhang D. Molecular mechanisms of uterine incision healing and scar formation // Eur J Med Res. 2023.
6. Nair A.D., Manchanda S., Gamanagatti S., et al. Post caesarean section complications conundrum: Role of imaging // Br J Radiol. 2022. Vol. 95, N 1138. P. 20211344.
7. Thurmond A.S., Harvey W.J., Smith S.A. Cesarean section scar as a cause of abnormal vaginal bleeding: diagnosis by sonohysterography // J Ultrasound Med. 1999. Vol. 18, N 1. P.13–16.
8. van der Voet L., Bij de Vaate A.M., Veersema S., et al. Longterm complications of caesarean section. The niche in the scar: a prospective cohort study on niche prevalence and its relation to abnormal uterine bleeding // BJOG. 2014. Vol. 121, N 2. P. 236–244.
9. Курцер М.А., Бреслав И.Ю., Барыкина О.П. и др. Расползание рубца на матке после кесарева сечения // Акушерство и гинекология. 2022. № 2. С. 59–64. EDN: FIMWTA
10. Rotas M.A., Haberman S., Levgur M. Cesarean scar ectopic pregnancies // Obstet Gynecol.2006. Vol. 107, N 6. P. 1373–1381.
11. Ohashi M., Tsuji S., Kasahara K., et al. Influence of cesarean section on postpartum fertility and dysmenorrhea: a retrospective cohort study in Japan // Womens Health Rep.2024. Vol. 5, N 1. P. 22–29.
12. Armstrong F., Mulligan K., Dermott R.M., et al. Cesarean scar niche: An evolving concern in clinical practice // Int J Gynaecol Obstet. 2023. Vol. 161, N 2. P. 356–366.
