THEORETICAL ASPECTS IN THE FORMATION OF
PEDAGOGICAL SCIENCES
International scientific-online conference
105
MODERN APPROACHES TO ASSESSING THE CONDITION OF THE
UTERINE SCAR AFTER CESAREAN SECTION
Kurbaniyazova V.E.
Samarkand State Medical University
https://doi.org/10.5281/zenodo.14928278
Relevance of the Topic.
The increasing number of cesarean sections
worldwide has led to a growing concern regarding the condition of the uterine
scar and its impact on future pregnancies. Scar insufficiency can result in severe
complications such as uterine rupture, abnormal placentation, and infertility,
necessitating the development of more precise diagnostic methods. Modern
technologies, including 3D ultrasound, elastography, and MRI, allow for a more
objective assessment of scar structure and functional integrity, aiding in the
selection of optimal pregnancy management strategies and reducing maternal
and perinatal morbidity.
Materials and Methods.
The study included 120 patients with a uterine
scar after a cesarean section, monitored during pregnancy planning (n=45) and
gestation (n=75). Scar condition assessment was performed using ultrasound
(2D and 3D) in 120 (100%) cases, elastography in 80 (66.7%), MRI in 35
(29.2%), and hysteroscopy in 25 (20.8%). The analysis of scar thickness (mean
2.8±0.6 mm), structure, and vascularization helped determine its integrity and
predict possible complications. The obtained data were correlated with
pregnancy and delivery outcomes to evaluate the diagnostic value of each
method and its influence on patient management strategies.
Results and Discussion.
The study found that the average scar thickness
was 2.8±0.6 mm, with signs of scar insufficiency identified in 38 (31.7%)
patients. Critical thinning (<2.0 mm) was observed in 19 (15.8%) cases, while
abnormal vascularization was detected in 22 (18.3%). Elastography revealed
decreased tissue elasticity in 28 (35%) of 80 patients, which correlated with MRI
findings, where 12 (34.3%) showed fibrotic changes. Hysteroscopy confirmed
thinning and defects in 9 (36%) of 25 cases, demonstrating its high accuracy in
visual scar assessment. A comparative analysis revealed that 3D ultrasound
combined with elastography and Doppler imaging had a high diagnostic value,
detecting scar insufficiency in 92% of cases, while MRI proved useful in complex
situations. These results highlight the necessity of a comprehensive, non-
invasive diagnostic approach to timely detect risks and select the best pregnancy
and delivery management strategy.
Conclusion.
The study confirms that a comprehensive assessment of the uterine
scar after cesarean section using 3D ultrasound, elastography, Doppler imaging,
THEORETICAL ASPECTS IN THE FORMATION OF
PEDAGOGICAL SCIENCES
International scientific-online conference
106
and, when necessary, MRI and hysteroscopy, enables highly accurate detection
of scar insufficiency and prediction of potential complications. 3D ultrasound
proved to be the most informative and accessible method, while elastography
and MRI provided additional insights in complex cases. An individualized patient
management approach based on scar condition assessment helps reduce the risk
of uterine rupture, improve pregnancy and delivery safety, and optimize the
indications for repeat cesarean section or vaginal delivery.
