A CLINICAL CASE OF AN UNDEVELOPED PREGNANCY IN A UTERINE SCAR AFTER A CESAREAN SECTION

M. E. Shchepelev, Tatyana V. Deripasko, Anastasiya A. Sidorova, E. G. Drandrova, E. V. Moskvichev, Tatyana Yu. Leonteva, D. A. Afanasev
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Abstract

Over the past twenty-five years, the average age of a woman giving birth to the first child has grown significantly around the world. So, in Russia, currently, women begin to bring their reproductive function into action on average at the age of 26-35. This leads to the fact that obstetricians and gynecologists in their practice increasingly face with pregnancy and childbirth complicated by a uterine scar after a previous cesarean section or myomectomy. The formation of a uterine scar after any intervention entails the likelihood of long-term complications, such as a rupture of the uterus along the scar and pregnancy in the uterine scar. According to the latest clinical recommendations for ectopic pregnancy, pregnancy in the uterine scar has been added to the anatomical classification of ectopic pregnancies. The article describes a clinical case of an undeveloped pregnancy in the uterine scar after a cesarean section, it shows the difficulty of timely diagnosis of such pregnancy, which often results in improper management of patients and loss of fertility by women of childbearing age. In the described case, late diagnosis of pregnancy in the uterine scar necessitated organ-resecting surgery – extirpation of the uterus with fallopian tubes.
剖宫产术后子宫瘢痕未发育妊娠的临床病例
在过去的25年里,世界各地女性生第一个孩子的平均年龄显著增长。所以,在俄罗斯,目前,女性平均在26-35岁开始发挥她们的生殖功能。这导致产科医生和妇科医生在他们的实践中越来越多地面对妊娠和分娩并发症的子宫疤痕后,以前的剖宫产手术或子宫肌瘤切除术。任何干预后子宫瘢痕的形成都可能导致长期并发症,如子宫沿瘢痕破裂和子宫瘢痕内妊娠。根据宫外孕的最新临床建议,宫内瘢痕妊娠已被加入宫外孕的解剖学分类。本文介绍了一例剖宫产术后子宫瘢痕未发育妊娠的临床病例,说明了这种妊娠难以及时诊断,往往导致患者管理不当,育龄妇女丧失生育能力。在上述病例中,子宫瘢痕妊娠的晚期诊断需要进行器官切除手术-用输卵管切除子宫。
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