Hemostasis system and uterine scar formation in women undergoing conservative myomectomy

Annotation. The aim of the study was to assess the characteristics of hemostasis and the formation of a scar on the uterus in women who underwent conservative myomectomy. Medical records of 426 women with a scar on the uterus were analyzed. The results of pathomorphological examination of biopsy materials obtained in the area of the “old” scar during myomectomy with recurrence of fibroids with a gestational age of 33 to 40 weeks. The micromorphological structure of postoperative scars and pericycatric region of the myometrium was determined and immunohistochemical examination was performed on serial paraffin sections of biopsy material using primary and secondary monoclonal antibodies of Dako kits (USA). To quantify the immunohistochemical results in the sections, the number of cells in which the immunoperoxidase label (positive staining) was detected in 10 fields of view randomly selected (>200 cells) was counted. FW expression was determined using a semi-quantitative method with H-score calculation. Statistical processing of the obtained results was performed by non-parametric methods using the software TIBCO Statistica 13.5 (USA). It was shown that 40.1% of uterine scars are due to conservative myomectomy. In the postoperative period, patients who underwent conservative myomectomy have a tendency to hypercoagulation, while the frequency of thromboembolic complications after conservative myomectomy does not exceed 3%. High FW expression indicates the presence of endothelial dysfunction and should be taken into account when assessing the risk of thromboembolic complications in patients after conservative myomectomy.