Clinical and morphological variants of insufficient uterine scar after cesarean section
11.12.2025
18:02
Russian researchers conducted a study aimed to explore the morphological features and clinical manifestations of insufficient uterine scar after cesarean section.
Three main morphological variants of insufficient uterine scar were identified – "inflammatory", "vascular" and "connective tissue". The clinical and morphological parallels of insufficient uterine scar were assessed taking into account the histological variant. The patients with the "vascular" type of insufficient uterine scar had a history of irregular menstrual cycles (r=0.71; 95% CI 0.81;0.89, p<0.001). The main indication for delivery was the risk of uterine rupture along the scar (r=0.67; 95% CI 0.78;0.95, p<0.001). The patients with the "connective tissue" type of insufficient uterine scar underwent the first cesarean section due to abnormal labor (r=0.81; 95% CI 0.65;0.74, p<0.001). Uterine scar insufficiency – thinning of the uterine scar (<2 mm) was detected by ultrasound. At the same time, the clinical picture showed no risk of uterine rupture along the scar (r=0.88; 95% CI 0.76;0.85, p<0.001). The "inflammatory type" of insufficient uterine scar correlated with recurrent miscarriage in history (r=0.65; 95% CI 0.58;0.83, p<0.001) and fetal distress in current pregnancy (r=0.63; 95% CI 0.61;0.81, p<0.001).
The obtained data indicate that there is a need for an in-depth study of the pathogenetic mechanisms of uterine scar formation and the development of a prediction model.
