Fetoplacental Insufficiency In Pregnant Women With Uterine Scar Defect

Background: Studies have shown, that poor healing and subsequent uterine scar defect were found to affect badly on pregnancy course and perinatal outcomes. One of significant problems of modern obstetrics – how to conduct pregnant woman with uterine scar defect.

Objective: to evaluate risk of fetoplacental insufficiency in case of defective uterine scar

Methods: Sonographic and cardiotocographic examination were performed between 36 and 39 weeks'gestation on 43 pregnant women (Group 1) with defective uterine scar (lower uterine segment thickness was less than 3.0mm, myometrium dehiscence, poor vascularisation, scar niches) and 48 pregnant female (Group 2) with consistent scar. Fetal cardiotocography was carried out by means of Rimkus T800 telemetric system with computer analysis.

Results: The highest proportion of pregnancy complication such as a threat of interruption, fetal growth restriction was observed in Group 1 (30.2% and 18.6%) compared to Group 2 (12.5% and 8.3% respectively). Circulatory disturbances of uterine arteries were found in 14 patients (32.5%) Group 1 and in 7 women (14.5%) Group 2; umbilical cord, fetal vessel blood flow disorders in 30.2% and 16.7% cases, joint circulatory disturbances in fetoplacental system had 7.0% and 4.2% women respectively. Cardiotocography revealed 2.1 times higher rates of fetal hypoxia in Group 1 (34.9%) than in Group 2 (16.7% patients).

Conclusion: The risk of fetoplacental insufficiency in pregnant women with uterine scar defect compared to female with consistent one was increased by 1.7 times.