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Estimated efficiency of uterine cavity suturing in patients during organ-preserving surgery with placenta increta while examining reproductive function in the postpartum period

https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.184

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Abstract

Aim: to assess the reproductive function of patients who underwent organ-preserving delivery using a modified method of uterine cavity suturing placenta increta.

Materials and Methods. There were retrospectively investigated 77 history cases of patients admitted for planned delivery in 2018–2020, subdivided into two groups: Group 1 (control) – 32 patients with uterine scar after previous cesarean section, Group 2 (main) – 45 patients diagnosed with placenta increta further assigned to 2 subgroups – 2A (n = 23) underwent a modified uterine cavity suturing, and subgroup 2B (n = 22) where a linear suturing was used.

Results. The groups studied were comparable on anthropometric data and reproductive history. The ultrasound examination of the uterus size 6 months later revealed more prominent changes in main group that might be due to larger volume of excised uterine tissue during surgery. Significant differences in subgroup 2A (uterus length – 54 [48; 62] mm, uterus width – 38 [29; 47] mm; p = 0.036 and p = 0.024, respectively) and subgroup 2B (uterus length – 51 [42; 60] mm, uterus width – 30 [24; 44] mm; p = 0.003 and p < 0.001) vs. control group (uterus length – 60 [55; 66] mm, uterus width – 48 [42; 54] mm) were observed. Magnitude of change in size and shape of the uterus were found in subgroup 2A vs. 2B (p = 0.022 for uterus length, p = 0.004 for uterus width). Examining intrauterine blood flow revealed no significant differences between the groups compared (p > 0.1).

Conclusion. Assessing results of the applied new method for uterine cavity suturing in patients with placenta increta showed a marked efficiency in maintaining anatomically most natural shape of the uterus and uterine cavity. Despite the results obtained, the problem of restoring female reproductive function after organ-preserving delivery remains a pressing issue relevant and requires to be further investigated.

About the Authors

E. A. Berg
Bashkir State Medical University, Health Ministry of Russian Federation
Russian Federation

Edward A. Berg – MD, Assistant, Department of Obstetrics and Gynecology

3 Lenin Str., Ufa 450008



A. G. Yashchuk
Bashkir State Medical University, Health Ministry of Russian Federation
Russian Federation

Alfiya G. Yashchuk – MD, Dr Sci Med, Professor, Head of the Department of Obstetrics and Gynecology

3 Lenin Str., Ufa 450008



I. I. Musin
Bashkir State Medical University, Health Ministry of Russian Federation
Russian Federation

Ilnur I. Musin – MD, PhD, Associate Professor, Department of Obstetrics and Gynecology

3 Lenin Str., Ufa 450008



Yu. N. Fatkullina
Bashkir State Medical University, Health Ministry of Russian Federation
Russian Federation

Yulia N. Fatkullina – MD, Postgraduate Student, Department of Obstetrics and Gynecology

3 Lenin Str., Ufa 450008



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For citations:


Berg E.A., Yashchuk A.G., Musin I.I., Fatkullina Yu.N. Estimated efficiency of uterine cavity suturing in patients during organ-preserving surgery with placenta increta while examining reproductive function in the postpartum period. Obstetrics, Gynecology and Reproduction. 2021;15(6):658-668. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.184

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ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)