Ультразвукова діагностика стану рубця на матці у вагітних та невагітних жінок

Abstract

The dynamic increase in the number of caesarean section in Ukraine and around the world remains one of the main topics of discussion, which is intensively discussing by leading scientists. The traditional assessment of the ability of the uterus scar during pregnancy, based mainly on the analysis of clinical and anamnestic data, is not high informative, and the ambiguous conclusions of the sonographic study indicate the need for further detailed study. Therefore, there is reason to believe that the development of criteria for ultrasound assessment of the condition of the uterus scar after previous cesarean section will use them to predict the possibility of spontaneous delivery in the future and remains relevant. The objective: study the features of ultrasound diagnosis of the condition of the scar on the uterus in pregnant and non-pregnant women. Materials and methods. Observations and retrospective analysis of medical records of pregnant women and birth histories in 150 women with a scar on the uterus after a previous cesarean section for the period from 2014–2019. Results. In women who became pregnant up to a year after the previous cesarean section, the most pronounced changes in blood flow were in the uterine arteries, especially during gestation 28–34 weeks. Also, in women with a failed uterus scar, changes in blood flow were most often observed in the uterine arteries at all levels and were significantly higher, compared with women with a capable uterus scar and women from the control group. In women with an insolvent uterus scar, the most pronounced changes in the indices of vascular resistance was observed in the uterine arteries, in particular the right uterine artery. Conclusion. The peculiarities of blood flow and vascular resistance in different vessels of the myometrium depending on the gestation period and the timing of pregnancy after a previous cesarean section. The obtained detailed ultrasound examination and mathematical calculation of the results of ultrasound examination of the uterus and postoperative uterus scar after previous cesarean section in non-pregnant women allowed to create a scale for assessing the condition of the uterus scar after previous cesarean section in non-pregnant women. Keywords: cesarean section, uterus scar, ultrasound, pre-pregnancy preparation of women.