Informative application of the instrumental diagnosis of scar integrity in the experimental model of the uterine cavity

2021 
Currently, the frequency of deliveries by cesarean section is steadily increasing. Independent childbirth in women with a uterine scar is one of the mechanisms of its reduction. Meanwhile, the delivery of this category of patients through the natural birth canal requires the development of a safe and effective method for assessing scar integrity in the early postpartum period. For this purpose, a new instrumental diagnostics method has been developed, with its information content compared to manual examination data in an experimental model of the uterus. Each model was made of a bovine heart and had three defects with diameters less than 0.5 cm, 0.5-0.8 cm and 0.8-1.2 cm. Defects with diameters less than 0.5 cm were not detected by any of the methods studied. Defects with a diameter of 0.5-0.8 cm were detected using the developed device in 90 % (45/50) of cases and using manual examination in 44 % (22/50) of cases (χ 2 = 23.93, p < 0.001), defects with a diameter of 0.8-1.2 cm being detected in 100% (50/50) and 98% (49/50) of cases, respectively (χ 2 = 1.01, p = 0.32). The information content of the instrumental model exceeds that of the manual study by 1.34 times (RR = 1.34, 95 % CI 1.09-1.65, p < 0.05). Therefore, the possibility of testing this device in clinical trials needs to be considered.
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