Perinatal pregnancy outcomes with uterine scar

Abstract

The increase in the frequency of surgical interventions on the uterus in women of fertile age caused increasing occurrence of pregnancies with one or more scars on the uterus. Purpose — to evaluate perinatal outcomes in women with a uterine scar. Materials and methods. The study involved 120 pregnant women who had a history of reconstructive surgery. The total sample was divided into the following clinical groups: I (n=70) — women who underwent conservative myomectomy, including 6 12 months before conception (group IA, n=30) and more than 1 year before conception (IB group, n=40); Group II (n=50) — women who underwent a cesarean section. All patients were examined in accordance with the order of the Ministry of Health of Ukraine No. 676 dated December 31, 2004 «On the approval of clinical protocols for obstetric and gynecological care» (as amended by the order of the Ministry of Health No. 782 (v0782282-05) dated December 29, 2005, No. 624 (v0624282-08) from 03.11.2008, No. 205 (v0205282-14) from 24.03.2014). Statistical processing was performed using the ANOVA method using post-hoc correction with Bonferoni. The null hypothesis was accepted at p<0.05 Results. When analyzing the results of measuring the main fetometric indicators, it was found that in most cases there were no deviations from the population standard values. Only 7 (5.8%) pregnant women were expecting the birth of children with low birth weight, they had a fetal weight that did not correspond to gestational age (so-called SGA — small for gestational age). There were no cases of perinatal mortality. There were 8 (6.5%) cases of children born with malnutrition. There were 2 children born with asphyxiation (1.6%). There were 5 (4.0%) with respiratory disorders syndrome, 6 (4.8%) with manifestations of conjugational jaundice. 4 (3.2%) cases of morphofunctional immaturity were registered. Perinatal lesion of the central nervous system of hypoxic-ischemic origin was detected in 3 (2.4%) newborns. Conclusions. With the correct choice of tactics for the management of pregnancy and childbirth in women who have undergone surgery on the uterus, the number of perinatal complications does not exceed the general population levels. The incidence of unfavorable perinatal outcomes does not exceed 19.4%. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: uterine scar, pregnancy, childbirth, complications, perinatal outcomes.