Histological Analysis of the State of the Scar After Operational Delivery
Keywords:
uterine scar, caesarean section, operative delivery, histology, atrophy, replacement by connective tissueAbstract
According to world scientists, the frequency of Caesarean section is 18.1%. Expansion of indications for CS is justified if it leads to a reduction in perinatal morbidity and mortality. It is known from the literature that CS surgery at a frequency of 8-10% of all births really leads to a decrease in perinatal mortality, but there is a study that shows that an increase in the frequency of abdominal delivery above 15-17% increases the likelihood of postoperative complications with unchanged perinatal mortality. The management of patients with a uterine scar requires a deeper study of this issue in order to develop optimal methods of delivery.
Purpose – Определить уровень коллагена IV типа (отвечающую за репарацию тканей) у пациентов с рубцом на матке.
Material and methods: The study was conducted in the obstetric department of the clinic No. 1 of the Samarkand Medical University. The work is based on the analysis of the results of a comprehensive examination of 103 patients of reproductive age with one scar on the uterus, which were divided into 2 groups and 4 subgroups in the period from 2018-2020. As a new method of study, the level of type IV collagen was determined in patients.
Results: To achieve this goal, prognostic significant clinical, anamnestic, instrumental criteria for assessing the state of the scar on the uterus were determined. The sera of all patients, regardless of the method of delivery, were studied by the enzyme immunoassay method. Limits of normal indicators; the level of antibodies, defined as M ± 2, was for antibodies to Collagen I from 0.012 to 0.059. When analyzing the results, no significant relationships were found between the level of antibodies, age and gender (p> 0.1).
The average level of antibodies to type I collagen in group 1 was 0.145±0.012, which is significant for healthy individuals (p<0.001 anti-Col I). An elevated level of anti-Col I was detected in 25 patients (26%).
Conclusion: For delivery through the natural birth canal of pregnant women with a uterine scar, the thickness of the uterine wall in the area of the scar, according to Doppler data, is from 3 mm to 7 mm and the level of antibodies to type I collagen is at least 349.55 μIU / ml.
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