Delivery after repeated reconstructive plastic surgery on the uterus
Barinov S.V., Tirskaya Yu.I., Lazareva О.V., Kadtsyna T.V., Chulovsky Yu.I., Kovaleva Yu.A.
Relevance: The frequency of congenital uterine malformations ranges from 4 to 10%. These malformations are characterized by morphological and functional inferiority of the organ, which contributes to the difficulty in the processes of implantation and placentation, causing infertility, miscarriage, abnormal variants of placentation.
Case report: The article presents an obstetric history of the course of three pregnancies of a patient with a bicornuate uterus: the first two pregnancies resulted in premature termination due to premature placental separation and premature rupture of the membranes complicated by chorioamnionitis and placenta increta; besides, the patient had cervical incompetence. The effectiveness of using a two-balloon Zhukovsky catheter in combination with a hemostatic suture in the patient at risk for obstetric bleeding during delivery was shown.
Conclusion: Repeated reconstructive plastic surgery on the uterus with the restoration of the normal anatomy of the uterine cavity, timely treatment of cervical incompetence made it possible to carry the third pregnancy. Successful delivery using a two-balloon Zhukovsky catheter in combination with a hemostatic suture gave a chance to complete the pregnancy and perform an organ-sparing operation.
Authors’ contributions: Barinov S.V. – developing the concept and design of the study, performing all three surgeries with metroplasty in the described patient; Tirskaya Yu.I. – writing the text; Lazareva O.V., Kadtsyna T.V. – collecting and analyzing the material, search for the data from the archive; Chulovsky Yu.I. – editing the article; Kovaleva Yu.A. – assistance during the delivery.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
Ethical Approval: The study was approved by the Ethical Review Board of the Omsk State Medical University, Ministry of Health of Russia.
Patient Consent for Publication: The patient provided an informed consent for the publication of her data and associated images.
For citation: Barinov S.V., Tirskaya Yu.I., Lazareva О.V., Kadtsyna T.V., Chulovsky Yu.I., Kovaleva Yu.A. Delivery after repeated reconstructive plastic surgery on the uterus.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (4): 162-167 (in Russian)
https://dx.doi.org/10.18565/aig.2024.3
Keywords
References
- Sugiura-Ogasawara M., Ozaki Y., Katano K., Suzumori N., Mizutani E. Uterine anomaly and recurrent pregnancy loss. Sem. Reprod. Med. 2011; 29(6): 514-21. https://dx.doi.org/10.1055/s-0031-1293205.
- Omoto A., Ishikawa H., Inoue M., Morimoto S., Koga K., Shozu M. Metroplasty increases the take-home baby rate by reducing pregnancy loss without changing the chance of conception in women with septate uterus: a retrospective, single-center, observational study. BMC Pregnancy Childbirth. 2023; 23(1): 860. https://dx.doi.org/10.1186/s12884-023-06191-3.
- Panagiotopoulos M., Tseke P., Michala L. Obstetric complications in women with congenital uterine anomalies according to the 2013 European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy Classification: a systematic review and meta-analysis. Obstet. Gynecol. 2022; 139(1): 138-48. https://dx.doi.org/10.1097/AOG.0000000000004627.
- Galamb Á., Pethő B., Fekete D., Petrányi G., Pajor A. A méhüreg anatómiai rendellenességei habituális vetélőkben [Uterine anomalies in women with recurrent pregnancy loss]. Orv. Hetil. 2015; 156(27): 1081-4 (in Hungarian). https://dx.doi.org/10.1556/650.2015.30136.
- Prior M., Richardson A., Asif S., Polanski L., Parris-Larkin M., Chandler J. et al. Outcome of assisted reproduction in women with congenital uterine anomalies: a prospective observational study. Ultrasound Obstet. Gynecol. 2018; 51(1): 110-7. https://dx.doi.org/10.1002/uog.18935.
- Ludwin A., Ludwin I., Coelho Neto M.A., Nastri C.O., Bhagavath B., Lindheim S.R. et al. Septate uterus according to ESHRE/ESGE, ASRM and CUME definitions: association with infertility and miscarriage, cost and warnings for women and healthcare systems. Ultrasound Obstet. Gynecol. 2019; 54(6): 800-14. https://dx.doi.org/10.1002/uog.20291.
- Ludwin A., Martins W.P., Nastri C.O., Ludwin I., Coelho Neto M.A., Leitão V.M. et al. Congenital Uterine Malformation by Experts (CUME): better criteria for distinguishing between normal/arcuate and septate uterus? Ultrasound Obstet. Gynecol. 2018; 51(1): 101-9. https://dx.doi.org/10.1002/uog.18923.
- Akhtar M.A., Saravelos S.H., Li T.C., Jayaprakasan K.; Royal College of Obstetricians and Gynaecologists. Reproductive implications and management of congenital uterine anomalies: Scientific Impact Paper No. 62 November 2019. BJOG. 2020; 127(5): e1-e13. https://dx.doi.org/10.1111/1471-0528.15968.
- Venetis C.A., Papadopoulo S.P., Campo R., Gordts S., Tarlatzis B.C., Grimbizis G.F. Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies. Reprod. Biomed. Online. 2014; 29(6): 665-83. https://dx.doi.org/10.1016/j.rbmo.2014.09.006.
- Ridout A.E., Ibeto L.A., Ross G.N., Cook J.R., Sykes L., David A.L. et al. Cervical length and quantitative fetal fibronectin in the prediction of spontaneous preterm birth in asymptomatic women with congenital uterine anomaly. Am. J. Obstet. Gynecol. 2019; 221(4): 341.e1-341.e9. https://dx.doi.org/10.1016/j.ajog.2019.05.032.
- Макиян З.Н., Адамян Л.В., Быченко В.Г., Мирошникова Н.А., Козлова А.В. Функциональная магнитно-резонансная томография для определения кровотока при симметричных аномалиях матки. Акушерство и гинекология. 2016; 10: 73-9. [Makiyan Z.N., Adamyan L.V., Bychenko V.G., Miroshnikova N.A., Kozlova A.V. Functional magnetic resonance imaging for the determination of blood flow in symmetric uterine anomalies. Obstetrics and Gynecology. 2016; (10): 73-9. (in Russian)]. https://dx.doi.org/10.18565/aig.2016.10.73-9.
- Бобкова М.В., Пучко Т.К., Адамян Л.В. Репродуктивная функция у женщин с пороками развития матки и влагалища. Проблемы репродукции. 2018; 24(2): 42-53. [Bobkova M.V., Puchko T.K., Adamyan L.V. Reproduction in women with congenital uterus and vagina anomalies. Russian Journal of Human Reproduction. 2018; 24(2): 42‑53. (in Russian)]. https://dx.doi.org/10.17116/repro201824242-53.
- Баринов С.В., Тирская Ю.И., Медянникова И.В., Жилин А.В. Способ остановки послеродового кровотечения. Патент RU2619404С1. Заявитель и патентообладатель: государственное бюджетное образовательное учреждение высшего образования «Омский государственный медицинский университет» Министерства здравоохранения Российской Федерации. Oпубликовано 15.05.2017. Бюллетень № 14. [Barinov S.V., Tirskaya Yu.I., Medyannikova I.V., Zhilin A.V. Method for stopping postpartum hemorrhage. Patent RU2619404C1. Applicant and patent holder: Omsk State Medical University of the Ministry of Health of the Russian Federation. Published 05.15.2017. Bulletin No. 14. (in Russian)].
- Баринов С.В., Тирская Ю.И., Медянникова И.В., Шамина И.В., Ралко В.В., Раздобедина И.Н., Гребенюк О.А., Ковалева Ю.А., Шавкун И.А. Новый подход к выполнению операций кесарева сечения при приращении предлежащей плаценты. Акушерство и гинекология. 2017; 10: 47-54. [Barinov S.V., Tirskaya Yu.I., Medyannikova I.V., Shamina I.V., Ralko V.V., Razdobedina I.N., Grebenyuk O.A., Kovaleva Yu.A., Shavkun I.A. A new approach to cesarean section for placenta previa accreta. Obstetrics and Gynecology. 2017; (10): 47-54. (in Russian)]. https://dx.doi.org/10.18565/aig.2017.10.47-54.
Received 12.01.2024
Accepted 02.04.2024
About the Authors
Sergey V. Barinov, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology No. 2, Omsk State Medical University, Ministry of Health of Russia, 644099, Russia, Omsk, Lenin’s str., 12, +7(913)633-80-48, barinov_omsk@mail.ru, https://orcid.org/0000-0002-0357-7097Yuliya I. Tirskaya, Dr. Med. Sci., Associate Professor, Department of Obstetrics and Gynecology No. 2, Omsk State Medical University, Ministry of Health of Russia,
644099, Russia, Omsk, Lenin’s str., 12, +7(913)145-28-17, yulia.tirskaya@yandex.ru, https://orcid.org/0000-0001-5365-7119
Oksana V. Lazareva, PhD, Associate Professor, Department of Obstetrics and Gynecology No. 2, Omsk State Medical University, Ministry of Health of Russia,
644099, Russia, Omsk, Lenin’s str., 12, +7(905)484-66-99, lazow@mail.ru, https://orcid.org/0000-0002-0895-4066
Tat’yana V. Kadtsyna, PhD, Associate Professor, Department of Obstetrics and Gynecology No. 2, Omsk State Medical University, Ministry of Health of Russia,
644099, Russia, Omsk, Lenin’s str., 12, +7(929)368-08-15, tatianavlad@list.ru, https://orcid.org/0000-0002-0348-5985
Yuriy I. Chulovsky, PhD, Associate Professor, Department of Obstetrics and Gynecology No. 2, Omsk State Medical University, Ministry of Health of Russia,
644099, Russia, Omsk, Lenin’s str., 12, +7(913)637-18-11, akusheromsk@rambler.ru, https://orcid.org/0000-0003-2541-7091
Yulia A. Kovaleva, obstetrician-gynecologist, Head of the Obstetric Department of Pregnancy Pathology, Perinatal Center of Regional Clinical Hospital, 6
44111, Russia, Omsk, Berezovaya str., 3, kovalevajulia71@yandex.ru, https://orcid.org/0000-0002-3689-1357