Metroplasty in the delivery of pregnant women with a history of two cesarean sections

Abstract

AIM: This study aimed to evaluate the effectiveness of metroplasty at the stage of abdominal delivery in women who had undergone two cesarean section operations.

MATERIALS AND METHODS: Between 2020 and 2022, 150 pregnant women were examined. The patients were divided into three groups: the first group included pregnant women who had undergone one cesarean section, and the second group included those with two operations. In these groups, metroplasty was performed at the stage of delivery. The third group (control group) included pregnant women with a history of two cesarean sections who underwent surgical delivery without excision of the scar tissue in the lower segment. Metroplasty was performed before fetal retrieval with the whole fetal bladder in accordance with the patent “method of metroplasty during operative delivery in women with two or more cesarean sections.” To assess the dynamics of changes in scar thickness, all women underwent ultrasound examination 2 h, 3 days, and 6 months after delivery.

RESULTS: Resection of the scar area on the uterus during repeated cesarean sections improved the residual thickness of the myometrium, which was determined by ultrasound examination 6 months after the operation.

CONCLUSION: The proposed technique allows the formation of a functionally sound scar on the uterus after two cesarean sections.

Keywords

cesarean section / scar “niche” / uterine scar / metroplasty / uterine scar failure

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