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Uterine Morbidity: Cesarean Section Scar Complications

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Hysteroscopy

Abstract

We are fascinated these days to read Poidevin’s prediction which has been realized in full. He wrote in 1961:

“A prediction of the acceptable rate in 10 years’ time would neither be prudent nor, in itself, of any real importance. Some individual obstetricians have already arrived at the stage when cesarean section delivery is resorted to all women deviating at all from the bounds of accepted normality. This policy quickly brings the rate up to 20 per cent or more. There are, furthermore, those enthusiasts who go almost the whole way in order to protect the pelvic floor and lower genitals from natural childbirth! For those who fear the cesarean section rate will “get out of hand,” let me predict that this tendency will automatically be corrected by one factor—uterine morbidity.

Uterine morbidity should no longer be crudely judged by the incidence of uterine rupture subsequent to cesarean section the thinking of the next decade should be more delicate.

The next decade should see a more critical attitude toward the uterine wound, particularly, as this group in the general population will continue to grow. A reassessment of operative techniques is indicated and modifications will undoubtedly be attempted” [1].

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Abbreviations

AIR:

Acute inflammatory reaction

AVF:

Uterine anteflexion

CD:

Cluster of differentiation or cell markers

CD31:

Cell markers for endothelial cells

CD4:

Cell markers for T-helpers

CD57:

Cell markers for natural killer cells

CD68:

Cell markers for macrophages

CD8:

Cell markers for cytolytic T cells or killer T cells

CS:

Cesarean section

CU:

Conventional units

EGFR:

Epidermal growth factor receptor

FG:

Fibrin glue

G:

Gauge

HSG:

Hysterosalpingography

IHC:

Immunohistochemistry

LUS:

Lower uterine segment

MMP9/MMP19:

Matrix metalloproteinases

MMR:

Maternal mortality ratio

MNCs:

Mononuclear cells

MPs:

Macrophages

MRI:

Magnetic resonance imaging

NPY:

Neuropeptide Y

NT:

Neurotransmitters

PGA:

Polyglicolic acid

PGP 9.5:

Protein gene product 9.5

PID:

Pelvic inflammatory diseases

PNLs:

Polymorphonuclear leukocytes

RMT:

Residual myometrium thickness

RVF:

Uterine retroflexion

SHG:

Sonohysterography

SMA:

Smooth muscle actin

STD:

Sexually transmitted diseases

TAS:

Transabdominal ultrasound

TVS:

Transvaginal ultrasound

VEGF:

Vascular endothelial growth factor

WHO:

World Health Organization

X-ray:

Roentgenography

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Acknowledgments

The authors would like to sincerely thank Mrs. Maya A. Bessarabova for her inestimable assistance of the manuscript preparation.

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Authors and Affiliations

  1. Laboratory of Human Physiology, Moscow Institute of Physics and Technology (State University), Moscow, Russia

    Ospan Mynbaev M.D., M.Sc., Ph.D., Sc.D

  2. Department of Topographic Anatomy and Operative Surgery, Section of Pelvic Topographic anatomy and Pelvic Surgery, Pirogov Russian National Research Medical University, Moscow, Russia

    Ospan Mynbaev M.D., M.Sc., Ph.D., Sc.D

  3. High Risk Pregnancy Unit, Maternity Department, City Clinical Hospital for Emergency Medical Services N4, Tukhachevsky str, 17, 355040, Stavropol Krai, Russia

    Tatiana I. Babenko M.D.

  4. Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Number 12, East Hafez Avenue, Bani Hashem Street, Resalat High Way, Tehran, Iran

    Firoozeh Ahmadi M.D. & Maryam Javam B.Sc

  5. Gynecologic and Obstetric Clinic, Sassari University, Viale San Pietro 12, 07100, Sassari, Italy

    Ivano Raimondo M.D.

  6. Ioannina University, Ioannina, Greece

    Ioannis P. Kosmas M.D., M.Sc., Ph.D., M.I.P.T

  7. Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow, Russia

    Ioannis P. Kosmas M.D., M.Sc., Ph.D., M.I.P.T, Anna A. Mishutina, Antonio Malvasi M.D., Andrea Tinelli M.D., Ph.D., M.I.P.T & Michael Stark M.D., M.I.P.T

  8. Obstetrics and Gynaecology Department, Al-Azhar University Hospital, Al-Azhar University, Elyounany Street, Abassia, Cairo, 11682, Egypt

    Nahed E. Allam M.D.

  9. Department of Obstetrics and Gynecology, Santa Maria Hospital G.V.M. Care & Research, Bari, Italy

    Antonio Malvasi M.D.

  10. Moscow Regional Research Institute of Obstetrics and Gynecology, Pokrovka 22a, Moscow, 101000, Russia

    Lidia S. Logutova M.D., Ph.D., Sc.D

  11. Gynecological Department, Moscow Regional Research Institute of Obstetrics and Gynecology, Pokrovka 22a, Moscow, 101000, Russia

    Natalia A. Shchukina M.D., Ph.D., Sc.D

  12. Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Department of Obstetrics and Gynecology, Vito Fazzi Hospital, Piazza Muratore, Lecce, Italy

    Andrea Tinelli M.D., Ph.D., M.I.P.T

  13. Department of Obstetrics and Gynecology, Women’s Hospital, University of British Columbia, Vancouver, BC, Canada

    Victor Gomel M.D., Ph.D.

  14. The New European Surgical Academy, Unter den Linden 21, Berlin, 10117, Germany

    Michael Stark M.D., M.I.P.T

  15. Department of Gynecological Oncology, Berlin Humboldt University Hospital Charite, Berlin, Germany

    Michael Stark M.D., M.I.P.T

  16. The ELSAN Group, Paris, France

    Michael Stark M.D., M.I.P.T

Authors
  1. Ospan Mynbaev M.D., M.Sc., Ph.D., Sc.D
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  2. Tatiana I. Babenko M.D.
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  5. Ioannis P. Kosmas M.D., M.Sc., Ph.D., M.I.P.T
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  9. Lidia S. Logutova M.D., Ph.D., Sc.D
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  11. Maryam Javam B.Sc
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  12. Andrea Tinelli M.D., Ph.D., M.I.P.T
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  14. Michael Stark M.D., M.I.P.T
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Corresponding author

Correspondence to Ospan Mynbaev M.D., M.Sc., Ph.D., Sc.D .

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Editors and Affiliations

  1. Department of Obstetrics and Gynaecology, Ospedale Vito Fazzi, Lecce, Italy

    Andrea Tinelli

  2. Hysteroscopy Unit, Gutenberg Institute, Malaga, Spain

    Luis Alonso Pacheco

  3. Hysteroscopy Unit, Hospital Del Mar, Barcelona, Spain

    Sergio Haimovich

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Mynbaev, O. et al. (2018). Uterine Morbidity: Cesarean Section Scar Complications. In: Tinelli, A., Alonso Pacheco, L., Haimovich, S. (eds) Hysteroscopy. Springer, Cham. https://doi.org/10.1007/978-3-319-57559-9_41

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  • DOI: https://doi.org/10.1007/978-3-319-57559-9_41

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