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.

1) Omsk State Medical University, Ministry of Health of Russia, Omsk, Russia; 2) Omsk Regional Clinical Hospital, Omsk, Russia

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

bicornuate uterus
metroplasty
pregnancy in a bicornuate uterus
repeated reconstructive plastic surgery on the uterus
pathological attachment of the placenta

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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/0000-0002-0357-7097
Yuliya 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

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