[On pregnancies with previous uterine scar]

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine

Context:

• Investigating pregnancies with a history of cesarean section or myomectomy.
• Analyzing outcomes in 161 cases with uterine scars.

Purpose:

• To assess the risks and complications associated with pregnancies following uterine surgical scars.
• To evaluate the relationship between scar age and pathological pregnancy outcomes.

Summary:

• Vaginal delivery rate was 9.4%. Abnormal placentation rates included placenta accreta spectrum (51.0% anterior wall, 7.5% adherent, 5.7% previa, 0.9% percreta).
• Postpartum hemorrhage, uterine rupture (4.1% in term pregnancies), and puerperal morbidity (6.6%) were observed.
• Pathological outcomes correlated with the time elapsed since uterine scar formation. Early and late abortions showed no severe complications.

Impact:

• Highlights the increased risk of placenta accreta spectrum and uterine rupture in pregnancies with prior uterine scars.
• Emphasizes the need for improved surgical techniques for uterine procedures to enhance future trial labor success.
• Stresses the importance of vigilant monitoring for abnormal placental implantation and uterine scar integrity.