RUPTURE OF THE UTERUS – EACH CASE HAS ITS OWN HISTORY
DOI:
https://doi.org/10.11603/24116-4944.2022.2.13454Keywords:
uterine rupture, uterine scar, diagnosis, treatmentAbstract
The aim of the study – to analyze the frequency of uterine rupture in women who underwent uterine surgery, and to evaluate the effectiveness of the clinical monitoring system in the pregravidarum and intragravidarum stage.
Materials and Methods. The study was carried out on the basis of the regional perinatal center and the city maternity hospital No. 5 (Odesa) during 2016–2021. 2633 histories of pregnancies of women with uterine scars were analyzed, of which in 1798 cases the scar was formed after cesarean section, and in 835 – after conservative myomectomy. The frequency of uterine rupture and life-threatening conditions for the parturient (near miss) is determined. An analysis of the compliance of the pregnant women's examination program with current clinical protocols was carried out. Statistical processing was carried out by parametric methods using MS Excel software (Microsoft Inc., USA).
Results and Discussion. The average age of women was 39.6±0.7 years. The frequency of uterine rupture in pregnant women with a scar on the uterus after caesarean section was 0.2 %, after conservative myomectomy – 0.1 %. The risk factors for PM were the patient's age over 35 years, the presence of repeated pregnancies in the anamnesis, errors in the implementation of the pregnancy management plan in the I–II trimesters. Complete ultrasonographic monitoring was performed only in 2 (40.0 %) of 5 patients, sonohysterography – in only one case (20.0 %).
Conclusions. The frequency of uterine rupture after conservative myomectomy does not exceed 0.1 %, after caesarean section – 0.2 %. The presence of uterine rupture in the anamnesis is not a contraindication to the implementation of the reproductive function in the future. One of the risk factors for uterine rupture in women who have undergone surgical interventions on the uterus is low compliance with measures of clinical monitoring of the functional state of the postoperative scar during pregnancy.
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