Investigation of uterine vessel perfusion of the failure uterus scar after cesarean section

Abstract

In modern conditions, due to the increased frequency of cesarean section, which is not only a method of surgical delivery of pregnant women, but also surgery, there are problems in the reproductive health of operated women.Given the solution of many aspects of re-cesarean section, the issues of determining the diagnostic criteria for failure of uterus scar, their diagnostic value and use in practical medicine remain debatable.The objective: the investigate the features of uterine perfusion in pregnant women after a previous cesarean section and develop criteria for predicting the failure of the uterus scar.Materials and methods. A comprehensive two-stage (before and during pregnancy) examination of 180 women with a uterus scar after a previous cesarean section for the period from 2014–2019. Women were divided into groups and subgroups depending on the time of pregnancy.Results. Based on the conducted clinical and anamnestic data and the results of ultrasound examinations of the operated uterus, we detected changes in the blood flow of the uterine arteries and developed an arterial perfusion index in pregnant women. Using the proposed index, the features of arterial perfusion in women of childbearing age, depending on the time of pregnancy and the failure of the uterus scar after a previous cesarean section. This allowed us to determine the limit values of this indicator for each group of women, in which the value of this indicator differed significantly from healthy women. The proposed limit levels of uterine perfusion allow to diagnose uterine perfusion disorders during pregnancy at different times.Conclusion. Determining the arterial perfusion index in pregnant women expands the diagnostic capabilities of physician in determining the condition of the postoperative uterus scar after a previous cesarean section and is an additional preventive measure to determine its failure. The output of the values of this indicator beyond the predicted threshold values will require additional diagnostic actions on the part of the physicians to find additional combined pathology that may affect uterine blood perfusion.