Maintaining pregnancy and childbirth in women with a scar in the uterus. The flow of the postoperative period and the emergence of possible complications

The scar in the uterus is a serious problem of modern obstetrics, especially if we consider that the frequency of the delivery by the operation of the cesarean section is constantly growing.

About the scar in the uterus they say when prompt intervention was performed on the uterus. The scar can never have muscular structurelike myometrium. It is always associated with the formation of connective tissue. If it is much, then it has a significant impact on contractile activity The uterus, sharply breaking it. This is due to the fact that the connecting tissue to the reduction is not capable.

The scar on the uterus during pregnancy in a woman may be a consequence of such operational interventions in the past as:

- conservative momectomy (removal of the myomatous node, followed by stroke of the uterus wall);

- stitching the wall of the uterus after perforation produced during the medical abortion.

For reparative processes in postoperative wound have an impact of a number of factors to which suture material, the features of the body regarding the formation of a certain type of collagen, from which the connecting fabric, the presence or absence of infection in the postoperative wound, operational technique (than it is better, the better the wound is healing).

What is an insolvent scar in the uterus?

To predict the course of pregnancy, it is very important to estimate the scar on the uterus after Cesarean. One of the reliable ways to assess its quality is an ultrasound in the first weeks of pregnancy. With the help of this method, the thickness of the postoperative scar in the uterus is measured, as well as the identification of possible niches, that is, defects along the scar.

Normally, the scar must have a thickness by the end of the ended period of pregnancy equal to 5 centimeters and more. As a rule, it is used to obtain reliable results either a vaginal sensor, or if an abdominal sensor is used, then it is necessary to fill well bladder. You can evaluate the wealth of the scar on the uterus both during pregnancy and at the stage of its planning. In the latter case, this will allow to identify an insolvent scar (complete failure) when without conducting certain medical events Pregnancy is contraindicated.

Indirectly estimate the wealth of the scar and by clarifying the features of the flow postoperative period. Some circumstances can talk about increased risk of having an insolvent scar.

Thus, the thinning of the scar on the uterus indicates its insolvency.

How does pregnancy occur in the presence of a scar on the uterus?

The scar on the uterus imposes a serious imprint on the features of the course of pregnancy. These features know every obstetrician gynecologist, so takes into account them at the stage of pregnancy. These should be attributed:

- increased frequency of the threat of abortion;

- development of placental insufficiency in the greater percentage of cases than in the overall population of pregnant women;

- Anomalies attaching placenta ( tight attachment, true rotation, placenta prelation).

Anomalies attachment placenta are the most serious problem. They can lead to appearance blood discharge During pregnancy during the presence of the placenta or may be the cause of the anomalies of the placenta separation. They, in turn, lead to increased frequency manual offices, as well as cases of the removal of the uterus about true rotation.

What a scar is insolvent and the causes of its formation

The scar is considered defective in two cases:

- if its thickness is less than 5 millimeters;

- There are defects (so-called niches).

Usually insolvent, the scar becomes in the case of the development of an inflammatory process or poor operations of the operation (the tissue is restored by the unheated). Certain signs allow you to suspect an insolvent scar on the layout during pregnancy.

- an increase in body temperature in the postoperative period was observed;

- the presence of a pathological separated from the wound, etc.

The suture material also has a direct impact on the wealth of the scar. So, Ketgut most often leads to the development of an insolvent scar. Vincle in this respect is the best suture material, as the fabric is well heal.

Grigory Rubtsov - Last Year's Eyes

How do you give birth with a scar in the uterus?

In the presence of a scarry, childbirth with the scar in the uterus can be dual:

- through natural generic paths (under constant ultrasound monitoring);

- by checking the cesarean section.

It should be understood that vaginal childbirth is possible only if the following conditions are observed:

- no testimony for cesarean section, which were in the first birth;

- the possibility of constant ultrasound observation;

The failure of the scar in childbirth can lead to a fatal outcome of both the mother and the child. Therefore, with any deviation from normal flow, such births should be completed by the operation of cesarean section in urgency.

The effect of cesarean section on the state of the uterus

Each operational intervention in the uterus does not pass without a trace. Therefore, at present, such a concept as a disease of the operated uterus has been formed in gynecology. It lies in the fact that the operation leads to different neurohumoral deviations. As a result, it is accompanied by a disruption of the menstrual cycle, painful syndrome and other unpleasant symptoms.

Thus, the number of operational interventions in the uterus in women in reproductive age It should be as low as possible. This will avoid certain problems in the future. Maurina Slavina Maryna Slavina

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Scar in the uterus and his effect on pregnancy

In the presence of a scar on the cervix during pregnancy, many women are concerned about his influence on repeated childbirth And the possibility of passing them naturally.

Causes of appearance

• Cesarean section

The type of operation, as a result of which the scar was formed in the uterus. If damage is the consequence of Cesarean, a woman should have an idea of \u200b\u200bwhich incision was performed. In the presence of a planned cesarean section, a transverse section of the bottom of the uterus is made. In this case, the likelihood of a full-fledged scar is high, which will endure re-pregnancy and childbirth. Placenta rustling, extra childbirthOr a short period of pregnancy, requiring caesarean section lead to the fact that a longitudinal cut is made in the uterus. This condition is unfavorable to the mercury of muscle fibers.

• Other reasons

The reason for the appearance of the scar can be transferred conservative momectomy, suturing perforations on the cervix or removal of the uterine pipe. Damage formed during momectomy is characterized based on the presence of an opening of the uterine. With a small amount of myoma, it is often located outside the uterus and the opening of its cavity is not required. In this case, a wealthy scar is formed and its thickness is sufficient to carry the child in the future. The perforation of the uterus during an abortion leads to positive results, if it was carried out only with the east of the hole itself, without the cut of the uterine wall.

The consistency of the scar

To predict pregnancy and further childbirth in the presence of a scar in the uterus, it is necessary to know the degree of its healing, based on which it is a wealthy (full) or insolvent. The scar in the uterus is wealthy if the muscle fibers after the operation restored completely and its norm ranges from 2.5 mm on the narrow site. This damage has an elastic structure capable of both reducing and stretching, so pregnancy with such a scar passes without complications. If the scar is mainly consisting of connective tissue, it refers to the discharge of defective, since it is not able to stretch or shrink. On how the scar will be restored in the uterus, several factors affect:

Postoperative pregnancy

The time interval between the operation and the onset of pregnancy plays an important role in healing the scar. For optimal formation, it is necessary at least 12 months. However, if pregnancy is planned, then you should not wait for more than 4 years after Cesarean, since the scar will turn the connective tissue and becomes less elastic.

Postoperative period

The flow of the period following the operation, as well as possible complications affect the consistency of the scar. The complications include intrauterine inflammation, weak reduction after childbirth, latency of the lapse followed by cleaning.

Status diagnostics

If you have a scar in the uterus you need to undergo a survey on its consistency even before the pregnancy comes. This is necessary for a more accurate forecasting of pregnancy with the scar and subsequent birth. If there is a risk of the insolvency of the scar, it must be detected outside of pregnancy. For damage survey, several methods are used:

• Hysterosalpingography

A reagent is introduced into the uterus after which the uterus and uterine pipes are investigated on X-ray equipment. Snapshots will show the state of the scar from the inside, its location, as well as the inner shape of the uterus, its neck and degree of deviation from the middle. Unfortunately, this study gives an incomplete picture, so applied as additional way Receiving information after Cesarean.

• Hysteroscopy

The most informative method of diagnosis is to examine the inside of the uterus using very thin optical deviceintroduced through the vagina. The study can be carried out only 8 months after Cesarean for 4 days of the menstrual cycle. A full-fledged scar should have a homogeneous pink color Without white enclosures.

This method is used after the pregnancy has come, since other methods are not allowed.

Indication to independent birth

In most cases, doctors are trying to be reinsured, and pregnancy with the scar ends with Cesarean. However, today the patient can give the opportunity to give birth to the baby in a natural way. The following conditions must be respected:

• Pregnancy has come no earlier than 24 months. after operational intervention. In this case, we can talk about the consistency of the scar and the ability of the surrounding tissues to withstand the load during the bouts;
• The examination of the ultrasound shows the wealth of the scar;
• The mass of the future child should be small. The norm does not exceed 3.5 kg. Otherwise, the scar on the uterus will not stand the load, the tissue thinning and the placenta detachment will occur;
• Births naturally allowed only in the presence of a head prepay;
• There must be the location of the placenta at the rear winding wall. Otherwise, the uterus can occur, which will lead to the asphyxia of the fetus and his death;
• Compliance with the size of the pelvis and the head of the future kid. Otherwise, high pressure will be rendered to the lower part of the uterus, which will lead to its coloring;
• Pregnancy passes if there is no more than one scar at the uterus;
• The fruit is developing without pathological changes and without the prelation of the placenta;
• The first caesarean occurred unscheduled or pregnancy proceeds with complications.

Painter free good doctor and cosmetologist

Testimony for cesarean sections

In addition to the above testimony during pregnancy with the scar, there may be factors that indicate mandatory cesarean.

• Untenable scar

This factor is detected both with the help of an ultrasound and in the presence of a certain symptomatics: the soreness of the scar, pain in the lower uterine segment and discomfort suggests that additional research is needed.

• Pregnancy time

If pregnancy has arrived earlier than 18 months. After Cesarean. The chance of an insolvent scar is quite large, so when natural childbirth Complications may occur.

• Power weight

If the rate of maximum weight of the child is exceeded and the mass is more than 3.5 kg, the front uterine wall is experiencing excessive load and stretching, so natural labor can be dangerous because the scar in the uterus may disperse.

• PREFERENCE OF PERVA

Birth with pelvic or foot prediction is accompanied by a high risk, both for the child himself and for the fempics. If a child lies ore and cross it is an indisputable factor for cesarean, regardless of the fact that pregnancy passes with the scar.

• Placenta location

When preserving the placenta, there is a high risk of its detachment, which will be wrapped with strong bleeding. If the placenta is located low on the front uterine wall, there is a high probability of its attachment to scar tissue, and it threatens chronic fetal hypoxia. Moreover, pregnancy with the scar can be dangerous in that the placenta is going on, and this also threatens the hypoxy of the fetus.

• Width pelvis

If the female has a very narrow pelvisThis can lead to a rupture of the uterus on the heading due to excessive tension of the tissues in its area.

• Number of scars

If there is more than one scar in the uterus, which appeared during the cesarean or other operational actions, then natural generic activity is impossible.

• Pathology of fruit

If the fruit is developing with pathological deviations, the delivery without surgery may be dangerous both for him and for the very feminication.

• The testimony of the first cesarean

If the first caesarean was performed in absolute indications, based on the state of health and clinical features, then the second genera cannot be natural.

Maintaining natural labor

Most doctors try to give preference to natural generic activities, but the scar on the uterus refers such fencers to the risk group, because the placenta and the discrepancy between the scar can occur. In this case, the natural generic process can only pass with certain equipment and conditions in the maternity hospital. Committed conditions include:

• Ultrasound and fetal monitoring

As soon as the patient with the scar comes to the hospital with the fights, it is necessary to immediately hold ultrasound procedure. Based on the results, the doctor will appreciate the position of the baby, the placenta, the state of the scar, as well as a number of other points affecting the natural generic activity. If the rate of all indicators is not exceeded, there is no reason for concerns. To have continuous control over the state of the fetus and listening to his heartbeat, a woman is connected to the CGT apparatus.

• Anesthesia and resuscitation

For smooth disclosure of the cervix and relaxation of muscles, the woman has been needed to make epidural anesthesia. In addition, there must be prepared operating and resuscitation for a woman and the future kid.

Contraindications for natural childbirth

Taking natural childbirth with the scar in the uterus is categorically prohibited:

• Stimulate the generic activity by oxytocin, since rapid labor with the scar can lead to the fact that the uterus will not stand and break;
• Use forceps or turning the fetus with improper preview;
• Wait for more than 15 hours with weak generic activities, the existence of the waters and the absence of the cutting of the cervix;
• The slightest manifestation of disturbing symptoms requires immediate intervention of doctors.

Cesarean section in the process of childbirth

If in the course of natural generic activities, there are difficulties on the part of the women in labor or the fetus are carried out by Emergency Caesarean. Complications include acute hypoxia of the fetus, premature expulsion spindle water And the lack of the opening of the cervix, detachment of the placenta, the rupture of the uterine muscles, bleeding, the threat of the uterus, the rotation of the placenta, etc.

Even if there is a scar in the region of the uterus there is a possibility of natural genera. Under all the conditions, the probability of breaking over the head of 1 out of 100 cases is observed. The main thing in time to consult with the doctor. Human birth, health to you and the future baby!

• Are natural childbirth possible?

Where is thin, there and breaks! Do you know such an expression? What is the wealth of scar on the uterus? What is a scar? In what cases does it occur? How much time do you need to fully formed? The thickness of the scar and consistency - whether these concepts are the same? Is it possible to the discrepancy between the scarcation during pregnancy? What are the conditions for natural genera for a woman if there is a scar on the uterus? Is it worth connecting the emotional component? Or is it just sober and competently assessing the situation? Let's analyze these questions in order.

Operational interventions in the body of women and possible consequences

Wonderful idea of \u200b\u200bnature - creating female organism In order to fulfill the holy and noble mission, to endure and give birth to a full offspring! The norm of a full-fledged family is the creation of conditions for fertilization, tooling and the birth of a healthy offspring. However, not every representative of the beautiful half of humanity can boast of pregnancy full women's health. On the way to healthy motherhood, various obstacles may arise, which, with a competent, correct, timely, qualified approach, can be overcome and allowed. We are talking about forced surgical interventions in the body of the women needed to adjust its health.

For example, such an operation as conservative momectomy can restore patients to conception. Delete Mioma, but retain the organ. However, after the produced surgical interventionAs a rule, a scar is always formed. The scar may occur with the various necessary plastic rehabilitation operations (when the uterine horn is removed, they operate the pipe or cervical pregnancy at the same time with a royal angle). The wall of the uterus will be perforated during the operation for the forced removal of the fetal egg, when hyperimulated labor, a gap can occur. Some women during pregnancy according to the indications when the doctors are impossible to prescribe a planned caesarean section. As a result, the integrity of the uterus is disturbed. After stitching the incisions, punctures or breaks in the uterus is formed by a scar. All this may have consequences during pregnancy.

Restoration of seams after surgery

The scar in the uterus is special view Education, which consists of myofibrils and connective tissue. It is located in the place where surgery was performed and disruption occurred, and then the restoration of the integrity of the wall of the uterus. Very important for further forecast of the state of the woman, the possibility of having a child and independent birth Analysis of the formation of the scar and recognition of its consistency. For this, there are a number of criteria by which the rate of the formed wealthy scar on the uterus is determined.

What signs characterize a wealthy (full) scar? It is elastic, stretched well during pregnancy. It forms full muscle fibers. When forming a scar, it is especially important what kind of dissection was performed. If the incision passed across muscle fibers, then the chances that they will grow well and restore more than if it was cut along. Plays the role of scar formation. Doctors believe that the best term that must pass after the operation, approximately 1-2 years old. But not more than 4 years, because The scar is converting a connective tissue, and this, in turn, reduces its elasticity.

Signs that indicate the inferiority (failure) of the scar, is its irregularity, the outdoor contour is intermittent, it is thinned in less than 3-3.5 mm. If more than 3-4 years after the operation passed, then a lot of connective tissue is formed in it, it becomes inelastic and can dispense with pregnancy.

Types of diagnosis

If the family decided to conceive the child and the woman's uterus at this moment, was already operational effect, it is necessary to diagnose the scar formed for forecasts of the planned pregnancy. If the operation passed not so long ago, the diagnosis will help determine the healing speed, answer the question of how the scar is formed, and evaluate it (the thickness of the scar and its consistency is different concepts!).

Planning and maintaining pregnancy with scars in the uterus to some extent differs from monitoring the future mother without deviations from the norm. The scar is a strong seal formed by the connective tissue and the fibers of the musometric layer of the uterus. This formation appears at the place of gap and the regeneration of the fallopian wall after surgical operation. The scar in the uterus during pregnancy - is there a chance to make a kid on the light on your own or prepare for artificial delivery?

The beneficial development of the fetus depends primarily on the state of the parent organism. If the surface of the uterus is marked after dissection in the past, this, of course, will immediately affect the development of a new life.

Where do the scars of pregnancy come from

A rough strip of fabric in the uterus appears not only after planned or emergency cesarean sections. The need to disrupt the integrity of the sexual muscular organ can be dictated by such factors:

• gynecological operations (excision of foci of adenomyosis, mioma nodes);
• interrupting pregnancy located in a pipe or cervix;
• negative consequences of artificial interruption of pregnancy or intrauterine survey;
• regenerative plastic of uterine anomalies (removal of the uterine horn, intrauterine partition).

What is the scar during pregnancy

The scarring is a natural process of regeneration of alive fabrics whose integrity was broken. The cutting sheath can be recovered by full or defective regeneration. In the first case, the wound is tightened with the predominance of smooth muscle cells of myocytes, in the second case, the material for scarring becomes durable fibrous connecting tissue.

Accordingly, the tight trail from the previous surgical cut, depending on the quality of healing, is classified, based on the degree of its consistency.

Wealthy (full) scar education

The scar is filled in mainly muscle tissue, the structure of which is largely reminiscent of the "native" fabric of the fallopian wall. A wealthy scar is distinguished by a high degree of elasticity, it is well stretched, declining and has sufficient potential to take on a strong pressure that the whole uterus is experiencing with an increase in the fetus and during the child's birth.

Insolvent (defective) scar education

The fabric of such a scar has nothing to do with the muscle. It is deprived of the opportunity to stretch and, therefore, will not shrink during the battles. Moreover, a dense tissue can simply crack, because it consists of mainly from the threads of the connective tissue, while the muscles and vessels are underdeveloped. During pregnancy, the scar of the uterus as it increases gradually thinning, and there is no possibility to influence this process in modern medicine.

If the defectiveness of the scar seal is highly manifested (the thickness does not exceed 1 mm, many non-ielastic fibers, there are niches and seals in the RubE), this can be a significant obstacle to maternity planning. Normally, the scar on the uterus in pregnancy is not less than 3.6 - 3.7 mm in thickness after 32 weeks of the "interesting" position, and at least 2 mm for a period of 37 weeks.

The specificity of the regeneration of the postoperative section

On the quality of splicing of dissected membranes, the influence of the following circumstances is largely affected:

Type of operation

So, the state of the scar is affected by the method of cutting the uterus during the cesarean section. With a planned operation and dusted pregnancy, the lower part of the uterus is cut across. The advantages of the transverse scar before the longitudinal are obvious: the fibers of the cut muscle tissue have a cross-arrangement in the uterus, so they are restored quickly and efficiently. With a longitudinal cut, the fibers, cut across the muscular stroke, are heal significantly slower. Indications for the longitudinal section are emergency delivery in the event of strong bleeding and pronounced hypoxia of the fetus, as well as a delivery on a period of less than 28 weeks.

When cutting out a benign uterine neoplasm by conservative momectomy, during which the tumor nodes are removed, great importance For successful regeneration of damaged tissue, the location of the cut-off nodes, the access of surgical intervention, as well as the dissection itself is the dissection of a holistic shell. Small misers that were formed outside the uterus are removed without operational opening of the uterine cavity. After such an operation, a fully wealthy scar is formed, by strength, the exceeding scars that remain after inside extensive operationWhen removed intermuscular misa.

The scar, which occurred in case of accidental damage to the uterus after an artificial interruption of pregnancy, has a more elastic structure, if during the operation the perforation hole only walked, additionally does not cut the wall of the uterus.

Terms of conception after surgery

The time interval after the operation is of paramount importance for the degree of scar regeneration. The full structure of muscle tissue is restored after 1 to 2 years after dissection. That is why doctors recommend women to plan a second pregnancy at the scar on the uterus on average 1.5 - 2 years after surgery. However, a long time between the first and second pregnancies (more than 4 years) is also undesirable, since the scar loses its elasticity due to an increase in the percentage of connective tissue in its structure.

Forecast for the recovery period and possible difficulties

The smaller the complications after the operation, the more recent will be the scar. Its normal formation may prevent such deviations from the norm after the cesarean section, as:

• endometritis - inflammation inland walls uterus;
• partial contraction of the uterus;
• partial rejection of the lastness of the uterus, which entails the need to scrape the uterine cavity.

Diagnostic scar learning in the uterus

When planning a re-pregnancy with the scar after Cesarean, it is important to pass full examinationto make sure of consistency rubtsov Education On the uterus. For this, specialists use several methods.

1. Ultrasound procedure. During the procedure, the doctor can estimate the state of muscle tissue and assume what the thickness of the scar in the uterus during pregnancy, to study the degree of healing at the place of past dissection on the presence of niche (plots in the framework of the scar that did not comgrud).
2. X-ray uterus. Using the procedure can be studied internal structure scar.
3. Hysteroscopy. Using special equipment, the doctor assesses the state of blood vessels located in the scar fabric, its color and shape.
4. MRI. This is the only method by which the volume of connective tissue and muscle fibers in the framework of the scar is determined.

Unfortunately, even such a large set of diagnostic methods will not give a doctor a detailed idea of \u200b\u200bthe viability or inconsistency of scars. You can check it only practically, that is, pregnancy and childbirth.

Features of pregnancy with the scar in the uterus

Pregnancy with the scar in the uterus is largely more difficult than the usual one. The scar often becomes the cause of the pathological formation of the placenta - low, edge or complete preview. In addition, in some cases there are different degrees of its improper turmoration into the basal, muscular layer or full germination to the outer layer. Pregnancy is unlikely to be able to keep if the embryo attaches to the scar region - forecasts in this case are untold.

After the occurrence of pregnancy, the state of scarsing is carefully observed with the help of ultrasound. As soon as the slightest fears for the preservation of the fetus, the future mother is hospitalized and, most likely, will leave under the supervision of the hospital until the birth.

Most of all you should fear the rupture of the uterus on the header during pregnancy. This happens if the scar has become too thin and excessively stretched during pregnancy. Predict dangerous state In the form of discrepancies, it is possible, focusing on the following specific features:

1. Feeling strong tension in the uterus area.
2. Intensive pain when palpation of the abdomen.
3. Strong neurotic cuts in the uterus.
4. Isolation of blood from the vagina.
5. Violation or lack of heartbeat in the fetus.

When the uterus breaks down on the head clinical picture Replenished with the following disturbing symptoms:

1. Painful pain at the bottom of the abdomen.
2. The rapid development of hypotension.
3. Nausea, vomiting.
4. Furious fights to full cessation.

As a result, the fruitlessness of the fruit in the womb is deprived of vital oxygen, and a woman in most cases is experiencing hemorrhagic shock due to massive internal bleeding. Unfortunately, this situation can be resolved very deplorable: the child dies, and the uterus has to be removed. There is a chance to save the situation, conducting an emergency operation of cesarean section, but for this you need a timely diagnosis of pathology.

Medical control of future mothers in the presence of complications

In the first months of pregnancy, the woman passes a common examination and, if necessary, consult with the doctors of related specialties. Pregnant will certainly prescribe an ultrasound study. The procedure will help reliably establish, in which the uterus attached the embryo. If this happened next to the fermenter in the front of the uterine cavity (that is, next to the scar), the pregnancy is likely to be interrupted by vacuum aspiration. The need for an artificial elimination of the fruit egg is due to the fact that the development of chorion in the immediate vicinity of the last place of the gap can provoke the thinning of the wealthy scarsing education and, as a result, the gap of the uterus itself. If you do not interfere in the situation, the child will be able to be born exclusively through the cesarean section. However, strict prohibitions for pregnancy even in this case are not, so the question of the preservation of the baby decides the pregnant itself.

Another planned screening in a complex with an ultrasound and analysis of the hormonal status of the FPK is carried out for 20 to 22 weeks of pregnancy. On this time it is possible to diagnose the anomalies in the development of the child, to establish whether its size corresponds to the amount of pregnancy, detect placental insufficiency if it is. Placental insufficiency is an indication for the immediate hospitalization of the future mother and monitoring it in stationary conditions.

If the pregnancy proceeds satisfactorily, and the scar in the Woman's uterus is a wealthy, the following scheduled survey is pregnant for 37 - 38 weeks of pregnancy. As a rule, all procedures are carried out where the woman plans to give birth. Plan a "scenario" in advance, thinking through a combination medicinal preparationsthat will be applied during childbirth. In such cases, as a rule, antispasmodics, sedatives and antihypoxic agents for stimulating blood flow in the uterus and placenta are used.

Scar in the uterus and natural childbirth

A woman who has suffered an operation in the uterus can give birth to a child independently, approve doctors. Rhodeworce with high probability will be held without complications, if the state of the future mother will meet the following requirements:

• only one cesarean section of the section in the past;
• caesarean section was produced by a cross section;
• high probability of the vast of scar;
• attaching the placenta in distance from the scar;
• lack of serious chronic diseases in the mother;
• lack of obstetric violations;
• position of a child head down in the uterus;
• the absence of the reason for which Cesarean was produced at the first birth.

Doctors also pay much attention The intrauterine development of the baby, and try to provide in advance to provide suitable conditions in order to carry out an emergency operation of caesarean section if the force majeure will arise.

In practice, the desire for pregnant to give birth on its own is not always possible. Completely explained by the stumbling block for natural genera at the scar in the uterus are:

• longitudinal dissearch of the uterus at the first operation of cesarean sections;
• narrow pelvis pelvis;
• the location of the placenta is close to scar formation;
• low placentating;
• several scars on the uterus.

Natural root separation at the rubar on the uterus. Video

Many women, with the presence of a scar on the uterus, fear to be pregnant. Is such fear justified?

Scar in the uterus, that he represents himself

Damage to the uterus during childbirth, abortions and other interventions is eliminated by the operational way - the seams are superimposed. After healing, the scar is formed - the outflow from the connective tissue, which over time is replaced with muscle. Its condition is important for the flow of subsequent pregnancy and generic activity.

Diagnostics of the state of the scar during pregnancy

If a woman has a generic activity ended through cesarean section, it is recommended to be pregnant not earlier than in 2-3 years.
The healing scar is inspected by a gynecologist when planning a subsequent pregnancy or after conception. There are 2 of its states - full and defective. Wealthy or fully believed is the one that when palpation does not cause painful sensations and practically does not stand out. The defective or untenable is still very felt and causes discomfort when examining a gynecologist.
If the conception occurred, and when inspected, the inconsistency of the scar was discovered - it threatens with some complications, so it is better to have a survey to another pregnancy.

Risk factors in the presence of scar and possible complications

The scar on the uterus, if he heal completely and the fabric managed to recover, it does not threaten her mother nor a child.
Inside the scar can cause:

• Miscarriage on any time.
• The pathology of the formation and functions of the placenta.
• Gap on the old seam.

In order for pregnancy and childbirth to be successfully, it is important to wait for the full healing of the scar, as well as choose a good medical center for childbirth.

Features of pregnancy with the scar in the uterus

Although a wealthy scar or not, throughout pregnancy for the future mother, strict observation is conducted. With every planned inspection, the gynecologist feels the scar and conducts an ultrasound examination.
At 35 week, the condition of pregnant women, alleged size and weight of the baby, the location of the fetus and placenta is fully analyzed. The decision is made about how childbirth will pass. It is also proposed hospitalization a few weeks before the delivery.

Features of conducting birth with a scar in the uterus

In most cases, caesarean section is recommended pregnant women with the scar in the uterus. On the modern stagewhen there are preparations that enhance the recovery of cells and plastic seams, possible variant Natural childbirth.
Indications to the natural delivery:

• The presence of one wealthy scar.
• The scar is at the bottom of the uterus.
• Pregnancy proceeds normally.
• The previous child is completely healthy.
• Confirmation of ultrasound O. normal condition uterus.
• Mine fruit.

Indications for generic activities through operational intervention at the scar on the uterus:

• Longitudinal seam.
• Third or fourth births in a row.
• Large child.
• Misconception.
• Ultrasound examination shows the failure of the scar.
• The placenta is located on the scar or very low.

In one and the second case, childbirth is under the supervision of specialists, after obstetrics carefully examine the state of the uterus under anesthesia.

Tarve the uterus on the old log

If the pregnancy passed normally, the probability of complications during childbirth comes down to zero. However, there remains the danger of the divergence of fabrics by the old seam, both during the tooling of the fetus and childbirth. It all depends on the type of scar and its condition at the time of pregnancy.
The rupture on the old seam occurs more often with the vertical tab. This was done in the old years during the cesarean section, it is now applied only in emergency cases. At the present stage, at the cesarean section, a horizontal incision is mainly used, which rarely diverges after healing during subsequent pregnancy.
If the rupture still happens when entering the fetus, it is necessary to urgently apply for medical helpThere is a real threat to the life of the mother and the child. It is possible to determine it by such symptoms:

• Strong pain on the site of the old seam.
• Education over the pubic under the skin of a solid roundness (the head of the fetus can crawl into the resulting breach).
• Painfulness In the abdominal cavity.

During childbirth, such signs are connected:

• The child began to go out and returned back.
• Fights were gone or weaker.
• At the time of silence, the fights strong pain continues.
• Change the cardiac rhythm of the fetus.

Sometimes the gap during the generic activity can occur imperceptibly. Therefore, observation is carried out during and thoroughly after delivery.
The scar in the uterus does not deprive a woman the opportunity to endure and give birth healthy child. It is important to plan a subsequent pregnancy and take care of a thorough study before conception.

More and more last years Women are experiencing problems with conception, having tolerance and a delivery. There are a lot of reasons for this: inflammatory diseases, age, poor health and so on. In most cases modern medicine Yet helps a representative of the weak gender to overcome his ailment. However, subsequently some methods of treatment appear on the uterus scars. How they arise and what are threatened - you will learn from the article. It is worth a separately mentioning that the scar can be dangerous

The scar is called tissue damage, which was subsequently eliminated. More often for this, a surgical method of embeding is used. Rightly dissected places glued with the help of special plasters and so-called glue. In simple cases, with non-test damage, the gap will grow independently, forming a scar.

This education may be anywhere: on the body or human bodies. Women have a particular importance to the scar in the uterus. Photos of this education will be represented by you in the article. Diagnose damage can be diagnosed with ultrasound, palpation, on tomography of different types. At the same time, each method has its advantages. So, during the ultrasound, the doctor can estimate the position of the scar, its size and thickness. Tomography helps to identify education reliefs.

Causes of appearance

Why do some women come on the scars on the uterus? Such damage becomes the consequence of medical interventions. Usually, the type of operation plays a big role. It can be planned and emergency. With the planned turnout, the uterus dishes in the lower segment of the abdominal cavity. After extracting the fetus, its layer laying is made. Such a scar is called transverse. With an emergency cesarean section, a longitudinal section is often produced. At the same time, the scar has the same name.

Processing damage can be the result of perforation of the uterus wall during gynecological procedures: scraping, hysteroscopy, introduction of the Navy. Also scars always remain after the removal of myoma surgical method. In these cases, the position of the scar does not depend on the specialists. It is formed where the operation was carried out.

Pregnancy and scar

If you have scars in your uterus, then the possibility of birth of a child depends on their state. Before planning, you must refer to the gynecologist. Specialist B. obligatory Certain a ultrasound study will determine the state and position of the scar. It will also be necessary to pass some tests. Before starting planning, it is necessary to cure infections. Subsequently, they may cause any problems with having to wear.

If the scar is located in the lower segment and has a cross position, then problems usually do not occur. The weak floor representative will examine and lend to plan a pregnancy. In the case when the scar turns out to be insolvent, thinned and consistent mainly from the connecting tissue - pregnancy can be contraindicated. However, in some cases, the hands of surgeons are creating miracles. And the woman can still give birth.

If you have a scar on a childbearing authority, then this will be announced by a specialist who will lead your pregnancy. At the same time, you need to tell about the existing fact at once, at the first visit, and not before the very kind. Maintaining pregnancy in women with damage to the uterus a history occurs somewhat differently. They are paid more attention. Also this category of future mothers regularly have to visit the Cabinet of Ultrasonic Diagnostics. Particularly participating such visits in the third trimester. Before childbirth, the ultrasound scar on the uterus is carried out almost every two weeks. It is worth noting that the rest of the diagnosis methods during the nipping of the child are not allowed. X-ray and tomography are contraindicated. The exceptions are only special difficult situations when it comes not only about health, but also about the life of a woman.

Rhodework can be carried out by two methods: natural and operational. The most common women themselves choose the second option. However, in the consistency of the scar and the normal well-being of the future mother, natural childbirth is quite admissible. To make the right choice, it is necessary to consult with an experienced specialist. Also during tribal activity and increases, the fighting is worth a periodic ultrasonic observation of the state of the scar and the uterus. Doctors control the fetal heartbeat.

Damage to the cervix

As practice shows, some women who have given birth independently have a scar on the cervix. He arises due to tissue rupture. In the process of the delivery, the woman feels painful contractions. For them begin sweat. If the cervix on this moment Did not fully revealed, they can lead to her rupture. For a child, this is not threatened. However, the woman subsequently has a scar on the cervix. Of course, after the delivery, all the fabrics are invented. But in the future it can become a problem in the following births.

Such a scar at the mouth of the cervical canal may appear after other gynecological manipulations: the removal of the polypa and so on. In all cases, the applied scar seems to be connective tissue. With a subsequent delivery, he simply does not stretch, leaving the cervix plot is unscrewed. Otherwise, damage has no danger for the feminine and her future child. Let's try to find out what the scars located in the orbate can be dangerous.

Attaching the fetal egg and its growth

If there is scars in the uterus, then after fertilization, the cell, the set of cells can gain themselves on them. So, it happens around two cases out of ten. At the same time, the forecasts are very deplorable. On the surface of the scar there is a lot of damaged vessels and capillaries. It is for them that feeds the fetal egg. Most often, such a pregnancy is interrupted independently during the first trimester. The consequence can be called not only unpleasant, but also dangerous. After all, the woman needs an ambulance medical Help. The decomposing fabrics of the embryo can lead to sepsis.

Incorrect attachment of the placenta

The scar on the uterus after the cesarean section is dangerous in that during the next pregnancy, it can cause the misfortune of the child's place. Often women face that the placenta is fixed close to the generic canal. At the same time, with the course of pregnancy, it migrates above. The scar can prevent such movement.

Presence of scar after damage children's Organ Often leads to a rotation of the placenta. The child's place is located on the scar area. Doctors highlight basal, muscular and complete rotation of the placenta. In the first case, forecasts may be good. However, natural labor is no longer possible. In full may require the removal of the uterus.

Future state

The scar in the uterus can lead to a violation of blood circulation in the childbearing authority. Wherein future baby It raises oxygen and all the substances they need. With timely detection of such pathology, you can treat and support with appropriate drugs. Otherwise, hypoxia arises, which is fraught with the delay of intrauterine development. In particularly severe situations, the child can remain disabled or die.

Growing uterus

In a normal non-refined condition, the thickness of the walls of the elementar organ is about 3 centimeters. By the end of pregnancy, they stretch to 2 millimeters. At the same time, the scar is also thinned. As it is known, the damage to the connective tissue is replaced. However, a large area of \u200b\u200bthe scar is represented by a muscular layer. In this case, the scar is recognized as wealthy. If damage is thinned up to 1 millimeter, this is not a very good sign. In most cases, specialists prescribe the future mother bedding and supporting drugs. Depending on the term of pregnancy and what the thickness of the scar in the uterus, a decision can be made about a premature trioment. This condition is dangerous to the consequences for the baby.

After childbirth…

Scars on the uterus after childbirth may also be dangerous. Despite the fact that the baby has already born, the consequences may arise for his mother. Scars are damage to the mucous membrane. As you know, after childbirth, every woman has bleeding. There is a process of separating mucus and residues food shells. These discharge are called Lochi. In some situations, the mucus can linger on the scar region. It leads to inflammatory process. A woman needs scraping, her body temperature rises, well-being deteriorated. In the absence of timely treatment, blood infection begins.

Aesthetic side

Often, the presence of a scar in the uterus is a reason for cesarean section. Many women at the same time concerns their subsequent appearance. The abdominal remains an ugly scar. However, much depends on the technique of the surgeon. Also do not stand at the site of cosmetology. If you wish, you can make plastic and hide the ugly seam.

Summarize

You learned about what a scar in the uterus, in what situations he appears and the danger. Note that if it is properly preparing for pregnancy and listen to the advice of an experienced doctor in its jurisdiction, then the outcome in most cases is good. The new mammy with the baby is discharged from the maternity branch in about a week. Do not be very upset, if you have a scar on the uterus. Before planning, be sure to contact your doctor, go planned research, pass all tests. After that you can get pregnant.

Specialists do not advise you to start planning pregnancy earlier than two years after receiving such an injury. Also do not delay with it. Doctors say that after 4-5 years, the scar will stretch almost impossible. Sometimes problems may begin during pregnancy and childbirth. All you are good!

As a result of the cesarean section on the body, the uterus remains seam, which in time is transformed into the scar. It can cause complications during re-pregnancy and childbirth, so the doctor must be examined in a timely manner. After evaluating the structure and type of scar, the gynecologist decides on the possibility of natural genera after the operation.

What is a scar and the reasons for his appearance

Matchbox is structural educationwhich includes the fibers of the myometrium (muscle tissue of the uterus) and connective tissue. It turns out as a result of the impaired integrity of the uterine wall and its subsequent plastic with a medical seam.

As a rule, incision in the uterus is sewn with a special continuous seam (double-row or single-row). The process applies self-sessive suture threads: Caproag, Vincle, Monocryl, Dexon and others. The seams are heal and completely absorbed in a few weeks or months, which depends on the individual ability of the body to the tissue regeneration. After childbirth, the gynecologist necessarily controls the seam healing process using an ultrasound to prevent internal inflammation.

Approximately 6-12 months in place of the seam is formed a scar. The process of its formation is long, since during the cesarean section is damaged not only the mucous surface, but also the nerve endings. That is why several days after surgery it is recommended to take systemic painkillers that do not affect the lactation process.

In addition to the operation of Cesarean, there are other factors for the appearance of a scar in the uterus.

1. Abortion. After scraping in the cavity of the hollow organ, the walls of the walls and fibrosis may appear, as a result of which small scars remain in the tissue.
2. Removal of formations: benign (cysts, polyps, misa) or malignant (uterine cancer). Such operations are always accompanied by a violation of the integrity of the uterine walls.
3. Rip uterus. Damage to the hollow organ may happen in hyperimulation of labor, rapid pathological types, multiple pregnancy, etc.
4. Crotch breaks, tricky ways, mastechnic cervical. When the neck of the 3 degree obtained in the process of natural genera, the fallopic walls are damaged, which requires the imposition of seams.
5. Treatment of erosion. Any pathology therapy (including surgical or laser removal, reception of drugs) leads to the formation of a scar at the place of erosion.
6. Ectopic pregnancy. Surgical excision is used to remove the fetus from the uterine pipe or neck, as a result of which scars remain on the wall of the hollow organ.
7. Plastic rehabilitation procedures. Seam appears after plastic uterus, for example, as a result of horns amputation.

During the year after the cesarean section, it is extremely undesirable to interrupt a new pregnancy by the method of scraping, since in the process the doctor may damage the fresh scar.

Types of scars on the uterus

The uterine scars after cesarean sections differ in structure and method of formation. The possibility of subsequent natural genera, the risk of pregnancy pathologies, gaps, etc. depends on their shape and type.

By structure, the scar can be wealthy and insolvent. And depending on the method of carrying out the cut, a transverse or longitudinal seam is formed.

Wealthy and insolvent scar

A wealthy postoperative scar is natural and normal with a sufficient level of elasticity. In its composition, muscle, not connective cells, which makes the scar the most close to the natural fabric of the uterine wall. Such a scar can withstand the pressure of the fetus during re-pregnancy and its passage by generic paths. Education thickness should be normal from 5 millimeters. During the subsequent pregnancy, it will gradually thread, and 3 mm will be considered a good indicator of thickness. Many doctors argue that even at 1 mm at the end of 3 trimester, the risk of discrepancies of the seam is insignificant.

What does a full-fledged scar look like on the cesarean sections

If the generated scar after the cesarean section has a thickness of up to 1 mm, then they are talking about its insolvency. This formation is inhomogeneously in structure, has various deepening or thickening around the perimeter, the thread. It prevails a connecting non-email fabric where muscle together with the active plexus of the vessels. The defective thinned scar is a contraindication for re-pregnancy, since as the uterus increases its fabric does not stretch, and breaks. As a result, intrauterine bleeding and hazardous implications for health can develop. Unfortunately, the thinning of the scar in the uterus is not controlled and is not amenable to therapy.

There are risk factors that provoke the formation of an insolvent Scar:

• corporate COP (incision is carried out along the uterus, as well as CME with the dissection of its fabrics);
• suture inflammation in the process of postoperative rehabilitation;
• new pregnancy in the first two years after the COP;
• abortion with scraping for rehabilitation period (about a year).

In order for the scar to fully formed, the recommended period before re-pregnancy or abortion is at least 2 years. During this time, it is desirable to be protected by hormonal or barrier contraception (except for intrauterine spirals).

The thickness of the insolvent scar after the cesarean section is the danger of follow-up planning

Transverse and longitudinal

In the process of planned COP, a transverse section is performed in the lower separation of the uterus. At the same time, neat and even cut edges are obtained, which are then easily compared and combat with suture.

A longitudinal incision is used in the case of urgent delivery by the COP method ( internal bleeding, acute hypoxia of the fetus, campus of umbilical cord, etc.). At the same time, the edges of the cut are difficult to compare, and the wound can be notified unevenly.

Pregnancy and childbirth if there is a scar

Gynecologists called the optimal period between the cesarean cross section and the planning of a new pregnancy - 2 years. During this time, a good wealthy scar is formed, which preserves elasticity. It is also not recommended to take a break for more than 4 years, since over time, the ability of the seam to stretching is reduced (muscle fibers are gradually weakened and atrophy). It should be borne in mind that the longitudinal scar is easier to be degenerative changes.

What risks should be expected pregnant with a postoperative scar in the uterus.

1. Incorrect placenta presence (edible, low, full).
2. Pathological splicing of placenta with a myometrium, basal or outer layer of uterus.
3. Attaching the fetal egg in the scar zone, which greatly increases the risk of miscarriage or premature birth.

If a woman got pregnant, but the scar threaded and became defective, then she was put in the hospital for preservation from 34 weeks. With a full-fledged scar, observation is needed in a couple of weeks to the PDR. The attending physician assesses the state of the uterus walls and decides on the possibility and feasibility of natural childbirth, their tactics of their maintenance, etc.

Repeated caesarean section

It is known that with an untenched scar in the uterus in most cases, a planned COP is carried out. As a rule, after the previous operation, all the same relative readings remain to surgical delivery, for example:

• anatomically or clinically (large child) narrow pelvis;
• damage to generic pathways;
• eastic cervical lack of cervical;
• multi-way;
• multiple pregnancy;
• prelation of the placenta;
• baby berry prediction.

In these cases, planned caesarean is assigned, and the wealth of the scar does not matter.

Also absolute indications for each subsequent COP are:

• scar after the longitudinal COP;
• postoperative scars on the uterus in the amount of more than one;
• confirmed on ultrasound inconsistency of the scar;
• placement placed or kid in the zone postoperative scarthat increases the likelihood of rupture of uterine tissues during natural contractions;
• weak or absent generic activity in patients with a wealthy scar.

Many patients experience that after each cesarean operation increases the risk of non-pending abortion and spontaneous abortion. In practice, after the second COP on the RubE, the question arises of the possible sterilization of a woman with a dressing method uterine pipes For guaranteed pregnancy prevention. With each new operation, the risk of inferiority of the scar is increasing that threatened dangerous consequences For the life and health of a woman. And as you know, most women ignore regular visits to the ultrasound in after labor period And pregnant with an infallible scar.

Natural childbirth

After the COP, natural generic activity is allowed subject to compliance with:

• no more than one expensive operation in the uterus in the entire history of the disease;
• transverse wealthy scar, which is confirmed by ultrasound and gynecological examination;
• the location of the placenta and the attachment of the fetus outside the scar zone;
• proper preservation of the fetus;
• unionless pregnancy;
• lack of indications for planned COP, complications and pregnancy pathologies.

According to medical statistics, only 30% of patients have a wealthy scar after surgery and the possibility of subsequent natural genera. The latter are held in a specialized maternity hospital, where not only the maternity hospital is located, but also an obstetric hospital with a surgical, neonatal and anesthesiological service. In the event of a rupture of the uterine, the woman in labor for 10 minutes should have emergency surgery - this is an important condition for natural genera. The process is necessarily accompanied by cardiomonitoring, which allows you to fix the heart activities of the fetus for the operational detection of hypoxia.

After natural genera, the doctor necessarily palpates the uterine walls to eliminate cracks and incomplete breaks in the scar zone. During inspection, temporary intravenous anesthesia. If a complete or partial discrepancy of the seam walls was detected during the survey, then an urgent breakout operation is prescribed, which will prevent intra-abdominal bleeding.

Tarve the uterus on the old log

It is the most common cause of damage to the integrity of the uterus during childbirth. Unfortunately, it often happens without certain symptoms, so the risk of postpartum complications increases.

What factors can point out the discrepancy of the old scar:

• thinning (thickness less than 1 mm) and releasing scar;
• hypertonus uterus;
• strong pain At the bottom of the abdomen;
• arrhythmic contractions;
• vaginal bleeding;
• wipening the heart rate of the fetus.

Already after the scar break occurred, the following symptoms are joined:

• acute unbearable abdominal pains;
• fever;
• sharp pressure drop;
• vomiting;
• weakening or complete cessation of generic activities.

In medicine, 3 stages of rupture of the uterine walls in the scream were distinguished.

1. Threatening. The integrity of the walls of the hollow organ is not yet violated, but the crack in the scar is observed. Pregnant can feel pain at the bottom of the belly on the right, especially when the seam zone palpation. Listed symptoms are indications of the planned COP. If the pathology is detected in the process of childbirth, there are painful and weak contractions, which practically do not contribute to the opening of the neck. Doctors stop generic activities and conduct an emergency COP.
2. . In a pregnant woman in the rupture of the uterine scar, a hematoma (cavity with blood) is formed, which can exit the vagina in the form of bloody clots. Pregnant marks matchtonePain in the scar zone. Uzist can diagnose weak heart activities, hypoxia of the fetus. In the generic period, the uterus is constantly in voltage and is not relaxing, severe abdominal pains and lumbosacers, vaginal bleeding may occur. Pulls are also weak and painful.
3. Follow Internal bleeding and classical symptoms are developing: the pallor of the skin, the expansion of the pupils and the evidence of the eyes, tachycardia or arrhythmia, surface breathing, vomiting, confusion or loss of consciousness. A complete rupture of the uterus often leads to the fact that the child along with the last is in the abdominal cavity.

The second and third stage of the gap suggests the cesarean section, resulting in an extraction of a child and the last, and reliable suture material impose into the place of the gap. Sometimes damage to the uterine walls occupy a large area and threaten the health of a woman, which is an indication for emergency amputation of a hollow organ. After the COP, the patient is translated into the intensive care unit.

If the scar broke into pregnancy and natural childbirth, what consequences can be expected:

• premature childbirth;
• acute hypoxia child, violation of its respiratory function;
• hemorrhagic shock in the mother (condition is caused by internal bleeding);
• intrauterine fetal death;
• miscarriages in the early stages;
• uterus removal.

Monitoring of the state of the uterine scar

The first year after the COP, the patient should be attended by specialists to control the resorption of seams and the formation of the scar. It is necessary to reveal possible risks and pathology with new pregnancy and childbirth.

The following techniques apply to estimate the structure of the scar.

1. Ultrasound. The main study that allows reliably to determine the dimensions of the scar (thickness and length), form, location, structure (the presence of niche or bulges). It is due to the ultrasound that the wealth of the scar is determined, and a crack or a threatening gap can be revealed.
2. Hysterography. X-ray examination The hollow organ is accurate, but not quite safe. It is applied in the case when it is necessary to consider the internal structure of the scar and assess the risks of breaks.
3. Hysteroscopy. A minimally invasive study of the organ cavity, for which the device is used. Hysteroscope. It allows you to more accurately determine the shape of the scar, its color, the quality of the circulatory network in the tissues.
4. MRI uterus. This method is used to further estimate the proportions of muscle and connective tissue in the scar structure.

Scars after CS: Quantity, can I remove

Medical statistics show that if the first births were carried out using the operation, then the following would be likely to be indicated to it. At the same time, many patients are worried about how many scars in the uterus will remain after each cesarean section.

Normally, upon subsequent operation, the doctor conducts excision of the old scar, removes spikes and forms a new one. Thus, it reduces the area of \u200b\u200bpossible damage during each surgical intervention. But there are situations when you have to do new second, Third, etc. Sow on the uterus. For example, if a woman has multiple pregnancy or large fruit, which led to an extracting of the uterus and change its position. Or the next caesarean section may not be planned, but emergency, which will require an imposition of non-transverse, but the second longitudinal seam. Also, this situation is possible in the pelvic prelation of the fetus.

It is difficult to predict how many scars in the uterus and stomach will remain after a series of COP. Each case is individual, and often the doctor makes a decision already during the operation.

Also, patients are interested in whether it is possible to remove all these scars in order to get pregnant and endure the child. First of all, the possibility of removal will depend on the viability of the scar.

It is formed in 3 stages. On the first one appears the primary scar - reddish-pink, uneven. On the second, it is compacted and acquires a purple shade. On the third scar, turns the connective tissue and whites (the process takes about a year). After the specified period, the doctor using an ultrasound or MRI appreciates the viability of the scar.

If the scar will be insolvent, and the new pregnancy is a danger to the life of a woman, the doctor can offer hysteroscopic metroplastics - an operation on excision of an old scar in the uterus. Under anesthesia with help special devices The doctor rejects the scar and forms a new one with a reliable suture. In the absence of a rush, characteristic of the cesarean section, the surgeon can make smooth seam edges that are easily compared, leaving the high probability of forming a wealthy thick scar. That is, it is possible to remove the scar on the uterus, but only strictly for medical testimony.

The scar in the uterus is the mandatory consequence of the cesarean operation. It is not considered a contraindication for a new pregnancy, but the formation should be under the control of the doctor. With an untenched or thinner scar, a special tactic of pregnancy and childbirth is required, which will prevent the uterus break.