DELIVERY OF PREGNANT WOMEN WITH ANTENATAL FETAL DEATH IN THE PRESENCE OF A UTERINE SCAR AFTER CAESAREAN SECTION

The question of choosing a method for terminating an undeveloped pregnancy in the second trimester of pregnancy in women with a uterine scar after cesarean section remains debatable. Target. To assess the efficacy and safety of medical abortion in patients with antenatal fetal death at 27-28 weeks of gestation and a uterine scar after a previous caesarean section. Materials and methods. An unblinded prospective cohort study was conducted (pregnant women and physicians were aware of the method of abortion). We included 15 patients with antenatal fetal death at 27-28 weeks of gestation and a uterine scar after caesarean section. A combination of mifepristone and misoprostol was used for medical termination of pregnancy. A clinical and statistical evaluation of the obtained data was carried out. Results. With medical abortion, the average duration of labor was 8.5 (95% CI 7.346–9.168) hours. The volume of postpartum hemorrhage was within 280.0 (95% CI 250.0–400.0) ml. Positive effect was achieved in 100% of cases. Pathology associated with separation of the placenta was detected in 2 (13.3%) cases, in these cases, manual separation of the placenta and removal of the afterbirth were performed. Conclusion. Medical abortion in patients with one uterine scar and antenatal fetal death at 27-28 weeks of gestation should be performed in all cases, provided there are no contraindications for vaginal delivery