INTRODUCTION
One of the most significant complications of the cesarean section is the endometriotic lesion of the postoperative scar on the uterus, which occurs when there is a «niche» in the scar on the uterus.
OBJECTIVE
To determine the clinical and anamnestic features of patients with endometriosis of an incompetent scar on the uterus after a cesarean section.
MATERIALS AND METHODS
A prospective cohort study was conducted that included 55 patients of reproductive age who underwent surgical treatment for inconsistency of the uterine scar after cesarean section in 2020 on the basis of the Ural Research Institute of Maternity and Infancy Protection of the Ministry of Health of Russia. The first group (I) consisted of 34 patients with endometriosis of an inconsistent uterine scar after a cesarean section, the second group (II) — 21 patients without endometriosis of an inconsistent uterine scar after a cesarean section.
RESULTS AND DISCUSSION
The duration of the menstrual cycle is significantly shorter in patients with endometriosis of the uterine scar — 27.3 days than in the group without endometriosis of the scar on the uterus — 30.7 days, p<0.05. Secondary infertility occurred significantly more often in group I, 37.8% (5) than in group II, 4.8% (1), p<0.05. An emergency caesarean section was performed much more often in the group of patients with endometriosis of an incompetent scar on the uterus 73.5% (25) than in the second group 33.3% (7), (p<0.05). The depth of the «niche» according to MRI data differed in two groups, group I — 5.6±0.5 mm, group II — 3.6±0.7 mm, p<0.05.
CONCLUSION
The defeat of an inconsistent scar on the uterus with endometriosis reliably develops more often after an emergency caesarean section during childbirth. A reduction in the duration of the menstrual cycle in patients with endometriosis of an inconsistent scar on the uterus after a cesarean section may be due, inter alia, to the history of genital endometriosis in this group of patients in combination with adenomyosis. This study shows that the presence of endometriosis of an incompetent scar on the uterus after cesarean section is a common cause of secondary infertility.
