The aim of this research was clinical and morphological evaluation of uterine scar after cesarean section by Gusakov’s technique (GT) and Stark’s technique (ST). To this purpose, we conducted a morphological and morphometric study of the scars after performing GT (group 1) and ST (group2) in women with multiple deliveries. The problem of incomplete uterine scar after cesarean section remains relevant now. This surgery has been conducted since ancient times and is regularly improved. The most common methods of cesarean section delivery used today are GT and ST. We examined morphologically 28 uterine scars after cesarean section stained with hematoxylin and eosin, by Mallory’s, method, by van Gieson’s method and performed immunohistochemical study using antibodies to collagen type IV, desmin, factor von Willebrand, vimentin as well as morphometric study. In both groups we observed ingrowth of muscle tissue into the scar area, mature connective tissue with moderate and strong expression of collagen type IV while pronounced expression, which was revealed only in the neurovascular bundles, was more common in the ST group. In our opinion, connective tissue in the cesarean scars in GM group was more mature compared with ST group and contained arterioles and large vessels. Thus, clinical, morphological, immunohistochemical and morphometric studies did not reveal signiﬁ cant differences in both groups. Scar vascularization was similar to that in mature scars. In all cases, practically all the scar was composed of muscle ﬁ bers, between which the layer of connective tissue was located with neurovascular bundle represented by major arteries. However, scars after cesarean section by Gusakov’s technique seemed to be more mature and complete restoration of myometrium occurred.
Key words: cesarean section, Stark’s technique, Gusakov’s technique, complete uterine scar