Interruption of Pregnancy in Women with the Uterine Scar: Potential Risks

Abstract

Summary objective: To assess the risks and identify effective and safe methods of abortion in women with uterine scar. Material: Literary sources published in the databases of Medline, PubMed, and others, of which 57 are included in this review. The main provisions: Termination of pregnancy in women with a scar on the uterus involves the use of any available method. For women with a scar on the uterus, it is necessary to prepare the cervix before a surgical abortion in all terms. Abnormal implantation of the embryo within the fibrous tissue of the scar after caesarean section can cause life-threatening bleeding of the mother during or after the termination of the pregnancy. Surgical excision of the affected area by hysteroscopic access, as well as transvaginal or transabdominal local administration of Methotrexate with or without an additional intramuscular dose of the same drug, seems to be optimal from the point of view of minimizing the frequency of complications. Conclusion: A scar on the uterus after caesarean section presents a high risk of abnormal attach-ment of the ovum and fatal bleeding during abortion. present in past medical history ): uterine scar (caesarean section or myomectomy), manual ectomy of placenta, multiple gestation, dilation and curettage, endometriosis, multiple confinement, advanced age of the mother, IVF induced pregnancy.