Zhelezov D. Prediction and prevention of obstetric and perinatal complications in women with an operated uterus

The thesis is devoted to an actual scientific problem – improving the prognosis and prevention of obstetric and perinatal complications in women with an operated uterus by developing a program to assess the condition of the uterine scar at the pre- and intragravid stage. The main risk factors for complications of pregnancy and childbirth in women who underwent reconstructive surgery on the uterus were age (OR = 1.6 (1.3–1.9)), time after surgery (OR = 1.9) (1.4–2.3)), signs of scar failure (OR = 3.7 (2.4–5.1)), the presence of extragenital pathology (OR = 2.1 (1.4–2.8)). The expression of receptors for estrogen, progesterone and proinflammatory cytokines in the endometrium and myometrium of women who had reconstructive surgery on the uterus varies with time. Algorithm of preconceptional preparation and clinical management of pregnancy in women who had reconstructive surgery on the uterus can reduce the number of perinatal complications to 19.4%.