Monitoring the Course of Pregnancy of Women with a Uterine Scar After a Caesarean Section in Anamnesis

Abstract

The analysis of observational data was carried out on the course of pregnancy of 150 patients with a uterine scar after a caesarean section in anamnesis. The nature of changes in the state of the scar with the course of pregnancy is discussed. A group of 64 patients with a favorable initial state of the scar (with a residual myometrium thickness of 3 mm or more) was identified, for whom the dynamics of scar changes do not aggravate the course of pregnancy. For the remaining 86 patients with an initially thin scar, an algorithm was constructed for early (by the 26th week of gestation) identification of a group with relatively satisfactory dynamics of scar thinning during pregnancy and a high-risk group to develop an insolvent scar. The nature of pregnancy complications associated with the presence of a scar on the uterus, the features of delivery of patients in the studied groups, and the role of metroplasty as a method of restoring the reproductive function of a woman in the process of pregravid preparation were studied.