Morphological estimation of incomplete uterine scar rupture (dehiscence) in post- cesarean deliveries. Immunohistochemical studies

Abstract

Objectives: No studies were found that analysed the properties of the caesarean scar, therefore the new study analysed the myometrial immunohistochemical expression of elastin, collagen type VI, alpha smooth muscle actin, smooth muscle myosin heavy chain, and endothelial cell marker CD31. The aim of the study was to determine the risk of uterine rupture in future pregnancies.

Material and methods: A total of 89 women of Caucasian ethnicity were eligible: 20 healthy pregnant women, who underwent repeat caesarean section complicated by incomplete uterine scar rupture before labour, and 69 healthy pregnant women, who underwent repeat caesarean section without subsequent uterine scar rupture as the control group. In all cases, uterine tissue sample from the scarred region was collected during the caesarean section operation.

Results: The lack of observed significant changes of elastin, collagen type VI, alpha smooth muscle actin, smooth muscle myosin heavy chain and endothelial cell marker CD31 concentrations in ruptured and unruptured uteri indicates that these components cannot be found to be a marker of risk of uterine rupture in future pregnancies.

Conclusions: It could be suggested that the examined components do not contribute to the mechanism of maintaining integrity and are not responsible for the biomechanical properties of the uterine scar.

Keywords: actin; collagen; elastin; endothelial cell marker CD3; myosin; uterine scar.