THE POSSIBILITIES OF USING INSTRUMENTAL DIAGNOSTICS OF SCAR INTEGRITY IN THE CONDITIONS OF AN EXPERIMENTAL MODEL OF THE UTERINE CAVITY
Relevance.Currently, the rate of delivery by caesarean section is steadily increasing. Independent childbirth in women with a scar on the uterus is one of the mechanisms for its reduction. Meanwhile, the delivery of this category of patients through the natural birth canal requires the development of a safe and effective way to assess the integrity of the scar in the early postpartum period. The purpose of the work. To develop a method of instrumental diagnostics that allows to examine the inner surface of the uterine cavity and assess the condition of the scar area in the first minutes of the postpartum period without the risk of embolic complications and without requiring an anesthetic aid. Materials and methods. The analysis of the information content of the developed method was carried out in comparison with a manual study in an experimental model of the uterus. Each model was made from a bovine heart and had 3 defects with diameters less than 0.5 cm, 0.5-0.8 cm and 0.8-1.2 cm. Results. Defects of 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), using manual revision in 44% (22/50) of cases (χ2 = 23.93, p < 0.001), defects with a diameter of 0.8-1.2 cm - in 100% (50/50) and 98% (49/50) of cases, respectively (χ2 = 1.01, p = 0.32). The informativeness of the instrumental assessment of the model integrity exceeds the informativeness of the manual study by 1.34 times (RR = 1.34, 95% CI 1.09-1.65, p < 0.057. Conclusion. Given the high information content of the developed method, it is necessary to consider the possibility of testing this device in clinical trials.