Pregnancy after repeat surgical delivery in a woman who had a history of reconstructive plastic surgery for uterine suture failures on Day 8 after cesarean section

Barinov S.V., Kadtsyna T.V., Tirskaya Yu.I., Medyannikova I.V., Lazareva, O.V., Chulovsky Yu.I., Stotskaya T.A.

1) Omsk State Medical University, Ministry of Health of the Russian Federation, Omsk, Russia; 2) Perinatal Center, Omsk Clinical Hospital, Omsk, Russia
Background. The problem of treating purulent endometritis after cesarean section remains relevant, since hysterectomy is frequently performed in uterine suture failures, which leads to a woman’s worse quality of life. Timely diagnosis of uterine suture failures makes it possible to perform reconstructive plastic surgery and to preserve the reproductive function.
Case report. The paper describes a clinical case of a favorable pregnancy and delivery in a pregnant woman with a uterine suture after three cesarean sections and metroplasty for uterine suture failure in postpartum endometritis. It depicts the complex usage of antibacterial therapy and the intrauterine sorbent VNIITU-1 after metroplasty for postpartum endometritis, which allows the effective elimination of pathogenic microorganisms and local detoxification. The combination application of Zhukovsky uterine and vaginal catheters shows a positive effect in preventing uterine bleeding and pelvic hematomas.
Conclusion. An integrated approach to treating postpartum endometritis, by using antibacterial therapy and the intrauterine sorbent VNIITU-1, can improve the outcomes of reconstructive plastic surgeries. The use of Zhukovsky balloon tamponade during delivery in pregnant women with a failed uterine scar after cesarean section permits the amount of blood loss to be reduced during reconstructive plastic surgeries.

Keywords

postpartum endometritis
uterine scar failure
metroplasty
cesarean section
uterine scar after metroplasty
relaparotomy

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Received 19.05.2021

Accepted 21.05.2021

About the Authors

Sergey V. Barinov, MD, Professor, Head of the Department of Obstetrics and Gynecology №2, Omsk State Medical University, Ministry of Health of Russia.
E-mail: barinov_omsk@mail.ru. ORCID: 0000-0002-0357-7097. 644099, Russia, Omsk, Lenin’s str., 12.
Tat’yana V. Kadtsyna, PhD, Associate Professor, Department of Obstetrics and Gynecology №2, Omsk State Medical University, Ministry of Health of Russia.
E-mail: tatianavlad@list.ru. ORCID: 0000-0002-0348-5985. 644099, Russia, Omsk, Lenin’s str., 12.
Yulia I. Tirskaya, MD, Associate Professor, Department of Obstetrics and Gynecology №2, Omsk State Medical University, Ministry of Health of Russia.
E-mail: yulia.tirskaya@yandex.ru. ORCID: 0000-0001-5365-7119. 644099, Russia, Omsk, Lenin’s str., 12.
Irina V. Medyannikova, MD, Associate Professor, Department of Obstetrics and Gynecology №2, Omsk State Medical University, Ministry of Health of Russia.
E-mail: mediren@gmail.com. ORCID: 0000-0001-6892-2800. 644099, Russia, Omsk, Lenin’s str., 12.
Oksana V. Lazareva, PhD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk State Medical University, Ministry of Health of Russia.
E-mail: lazow@mail.ru. ORCID: 0000-0002-0895-4066. 644099, Russia, Omsk, Lenin’s str., 12.
Yuriy I. Chulovsky, PhD, Associate Professor, Department of Obstetrics and Gynecology №2, Omsk State Medical University, Ministry of Health of Russia.
E-mail: akusheromsk@rambler.ru. ORCID: 0000-0003-2541-7091. 644099, Russia, Omsk, Lenin’s str., 12.
Tamara A. Stotskaya, doctor of the Department of Pregnancy Pathology, Regional Clinical Hospital, Perinatal Centre. E-mail: tamara.stotckaja@yandex.ru.
ORCID: 0000-0002-6526-4328. 644000, Russia, Omsk, Berezovaya str., 3.

For citation: Barinov S.V., Kadtsyna T.V., Tirskaya Yu.I., Medyannikova I.V., Lazareva, O.V., Chulovsky Yu.I., Stotskaya T.A. Pregnancy after repeat surgical delivery in a woman who had a history of reconstructive plastic surgery for uterine suture failures on Day 8 after cesarean section.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 8: 236-241 (in Russian).
https://dx.doi.org/10.18565/aig.2021.8.236-241

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