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Obstetrics and Gynegology2024№9
Uterine scar defect after cesarean...

Uterine scar defect after cesarean section: diagnostic issues

DOI
https://dx.doi.org/10.18565/aig.2024.158

Danilov A.A., Martynov S.A., Adamyan L.V.

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia

Currently, operative abdominal delivery remains highly frequent, and this determines the relevance of the issue of uterine scar and associated complications. Uterine scar defect (USD) is associated with a large number of complications, including uterine rupture and placenta increta, infertility, and ineffectiveness of assisted reproductive technologies. The article presents a review of modern methods of scar diagnosis after cesarean section (ultrasound, MRI, sonohysterography, hysteroscopy), including techniques that can assess the qualitative characteristics of tissues (elastography, functional MRI). Despite the numerous proposed techniques, there is no gold standard for assessing the quality of the scar after cesarean section. It should be noted that the correlation between the mathematical parameters of the scar defect and adverse pregnancy outcomes explains the considerable diversity of the data obtained and cannot be considered unambiguous. The assessment of qualitative scar characteristics is of particular importance.
Conclusion: Despite the variety of techniques, to date there is no gold standard for diagnosing USD. In this regard, the development and implementation of methods that not only increase the accuracy of USD diagnosis, but can also assess the qualitative properties of the scar and adjacent myometrium are of particular importance. Therefore, the introduction of functional diagnostic methods seems to be the most promising and needs further study.

Authors’ contributions: Martynov S.A., Adamyan L.V. – concept and design of the article, editing; Danilov A.A. – collection and analysis of material, writing the text.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was carried out without sponsorship.
For citation: Danilov A.A., Martynov S.A., Adamyan L.V. Uterine scar defect after cesarean section: diagnostic issues.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (9): 22-27 (in Russian)
https://dx.doi.org/10.18565/aig.2024.158

Keywords

uterine scar defect after cesarean section
niche
ultrasonography
elastography
functional magnetic resonance imaging
Full text (in Russian)

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Received 06.07.2024

Accepted 06.09.2024

About the Authors

Anton A. Danilov, PhD student at Gynecological Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,
117997, Russia, Moscow, Ac. Oparin str., 4, +7(495)438-77-83, an_danilov@oparina4.ru, https://orcid.org/0009-0005-2461-5354
Sergey A. Martynov, Dr. Med. Sci., Leading Researcher at Gynecological Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,
117997, Russia, Moscow, Ac. Oparin str., 4, +7(495)438-77-83, s_martynov@oparina4.ru, https://orcid.org/0000-0002-6795-1033
Leyla V. Adamyan, Dr. Med. Sci., Professor, Academician of RAS, Deputy Director for Science, Head of the Department of Operative Gynecology, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, +7(495)438-77-83, l_adamyan@oparina4.ru,
https://orcid.org/0000-0002-3253-4512

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