Biomedical subjects
Publications and source records attributed to L S Mareeva.
A single-row suturing of the incision on the uterus after cesarean section with separate muscular-muscular sutures by synthetic dissolving threads holds good promise. Such suturing helped optimize the reparative processes in the uterine cicatrix and reduce the incidence of postoperative pyoseptic complications. Kaproag, an antibacterial suture material made in this country, proved to be the best for the purpose.
Successful management of 26 normal deliveries has demonstrated a high diagnostic value of ultrasonic examination of the cicatrix on the uterus before, during, and immediately after delivery. Employment of this method to choose the strategy of labor management helped reduce the number of vaginal examinations in a number of cases and do without control manual examinations of the postpartum uterine cavity.
Ultrasonic examination of the suture site on the uterus was carried out in 7-10 days following a cesarean section in 73 women. Several types of characteristic echograms were distinguished, evidencing the adequacy of the reparative processes at the site of suture on the uterus. The authors find the double-contrast echoscopic examination of the postoperative uterus highly effective, and much more informative than common ultrasonic examination. Synthetic suture material is recommended.
A review of the outcomes of 819 cesarean sections and the causes of intranatal and early neonatal loss of full-term newborns has demonstrated that postcesarean perinatal mortality and morbidity remains fairly high. Perinatal losses are largely seen in cases of late gestosis and placental disorders, i.e. where cesarean section is performed urgently for maternal reasons. Possibilities for improving perinatal parameters are in the optimization of indications for surgical delivery and timely as well as technically correct performance of the operation and high-quality anesthesiologic support at a specialized facility, well-equipped for urgent maternal and neonatal treatment and intensive care.
Hysteroscopy was used for the assessment of the uterine scar in 32 women one year after cesarean section. There was complete muscularization in 18 cases, partial replacement of muscular tissue by connective-tissue elements in 8 cases, and full replacement, in 6. Hysteroscopy may be used to set the time for the next pregnancy and predict the course of labor.
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