HEALTH OF WOMAN. 2015.8(104):116–118; doi 10.15574/HW.2015.104.116 
 

Choice of a method of delivery and other components of obstetric care in women with uterine scar and increased risk of infectious complications 

Zasadnyuk O. Р., Bevz G. V.

Vinnytsia regional clinical hospital named after. M. I. Pirogov

Vinnitsa national medical University M. I. Pirogov 

The objective of the study was to establish a method of delivery and other elements of obstetric care that the most significantly influence the rate of postpartum septic complications in women with uterine scar and explicit infection risk factors.

We examined 89 pregnant women with a mean age of 28.55±4.42 years (20 to 41) with a postoperative uterine scar. The patients were distributed into 2 groups: an index group (n=43) consisting of women who delivered at reference clinics during 2012 in accordance with standard methods of delivery for women with an uterine scar; and a control group (n=46) consisting of women who delivered in 2012 with a departure from standard delivery and postpartum course compared to the index group of patients.

We found out that successful vaginal delivery (b=-0.342, p=0.012), an application of a single-row vicryl suture for closure of uterus in case of abdominal delivery (b=-0.329, p=0.002), immune response modulation in postoperative period (b=-0.263, p=0.013), and reduction of pre-natal stay of pregnant patients at hospital up to 3 days or less (b=0.2643, p=0.014) were of crucial importance for decreasing an incidence of postpartum purulent inflammatory complications in pregnant women with uterine scar and increased risk of infectious complications.

For women with uterine scar and increased risk of infectious complications, a method of vaginal delivery should be considered a preferable one in absence of contraindications. Modern methods of obstetric care to pregnant women with uterine scar reduce the incidence of postpartum purulent inflammatory complications in women with increased risk from 28.2% in the control group to 9.3% in the index group (p=0.023). 

Key words: uterine scar, postpartum purulent inflammatory complications, risk factors. 

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