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Risk factors for incomplete healing of the uterine incision after caesarean section.

Vikhareva, Olga LU and Valentin, Lil LU (2010) In BJOG: An International Journal of Obstetrics & Gynaecology2000-01-01+01:00 117(9). p.1119-1126
Abstract
OBJECTIVE: To determine which factors increase the risk of large caesarean scar defects as assessed by transvaginal ultrasound. DESIGN: Observational cross-sectional study. SETTING: University Hospital. POPULATION: One hundred and eight women who had undergone one caesarean section. METHODS: Transvaginal ultrasound examination of the scar in the uterus 6-9 months after the caesarean. Published ultrasound definitions of large scar defects were used. Clinical information was obtained from medical records after all ultrasound images had been evaluated. MAIN OUTCOME MEASURES: Factors increasing the risk of large caesarean scar defects. RESULTS: Twenty-two (20%) women had a large caesarean scar defect. The odds of a large defect increased with... (More)
OBJECTIVE: To determine which factors increase the risk of large caesarean scar defects as assessed by transvaginal ultrasound. DESIGN: Observational cross-sectional study. SETTING: University Hospital. POPULATION: One hundred and eight women who had undergone one caesarean section. METHODS: Transvaginal ultrasound examination of the scar in the uterus 6-9 months after the caesarean. Published ultrasound definitions of large scar defects were used. Clinical information was obtained from medical records after all ultrasound images had been evaluated. MAIN OUTCOME MEASURES: Factors increasing the risk of large caesarean scar defects. RESULTS: Twenty-two (20%) women had a large caesarean scar defect. The odds of a large defect increased with cervical dilatation at caesarean (0 cm, 1-4 cm, 5-7 cm, 8 cm or more; odds ratio [OR] 4.4 [95% CI 0.7-28.5]; 26.5 [4.3-161.8]; and 32.4 [6.1-171.0]; P < 0.001), station of the presenting part at caesarean below pelvic inlet (OR 14.1 [4.6-43.1]; P < 0.001), duration of labour at caesarean (0 hour, 1-4 hours, 5-9 hours, 10 hours or more; OR 2.0 [0.2-23.8]; 13.0 [2.2-76.6]; and 33.1 [6.6-166.9]; P < 0.001), oxytocin augmentation (OR 6.3, [2.3-17.3]; P < 0.001), retroflexed uterus at ultrasound examination (OR 2.9 [1.0-8.3]; P = 0.047). According to multivariate logistic regression, no variable added information to cervical dilatation or the station of the presenting fetal part at caesarean. CONCLUSIONS: Caesarean in advanced labour is associated with increased risk of incomplete healing of the uterine incision as determined by transvaginal ultrasound. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
caesarean section, caesarean scar defect, ultrasonography
in
BJOG: An International Journal of Obstetrics & Gynaecology2000-01-01+01:00
volume
117
issue
9
pages
1119 - 1126
publisher
Wiley-Blackwell
external identifiers
  • wos:000279532500012
  • pmid:20604776
  • scopus:77954396592
ISSN
1471-0528
DOI
10.1111/j.1471-0528.2010.02631.x
language
English
LU publication?
yes
id
30dc7f16-ab08-40c3-babd-4271300278d8 (old id 1645287)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20604776?dopt=Abstract
date added to LUP
2010-08-02 10:37:18
date last changed
2018-07-15 03:11:36
@article{30dc7f16-ab08-40c3-babd-4271300278d8,
  abstract     = {OBJECTIVE: To determine which factors increase the risk of large caesarean scar defects as assessed by transvaginal ultrasound. DESIGN: Observational cross-sectional study. SETTING: University Hospital. POPULATION: One hundred and eight women who had undergone one caesarean section. METHODS: Transvaginal ultrasound examination of the scar in the uterus 6-9 months after the caesarean. Published ultrasound definitions of large scar defects were used. Clinical information was obtained from medical records after all ultrasound images had been evaluated. MAIN OUTCOME MEASURES: Factors increasing the risk of large caesarean scar defects. RESULTS: Twenty-two (20%) women had a large caesarean scar defect. The odds of a large defect increased with cervical dilatation at caesarean (0 cm, 1-4 cm, 5-7 cm, 8 cm or more; odds ratio [OR] 4.4 [95% CI 0.7-28.5]; 26.5 [4.3-161.8]; and 32.4 [6.1-171.0]; P &lt; 0.001), station of the presenting part at caesarean below pelvic inlet (OR 14.1 [4.6-43.1]; P &lt; 0.001), duration of labour at caesarean (0 hour, 1-4 hours, 5-9 hours, 10 hours or more; OR 2.0 [0.2-23.8]; 13.0 [2.2-76.6]; and 33.1 [6.6-166.9]; P &lt; 0.001), oxytocin augmentation (OR 6.3, [2.3-17.3]; P &lt; 0.001), retroflexed uterus at ultrasound examination (OR 2.9 [1.0-8.3]; P = 0.047). According to multivariate logistic regression, no variable added information to cervical dilatation or the station of the presenting fetal part at caesarean. CONCLUSIONS: Caesarean in advanced labour is associated with increased risk of incomplete healing of the uterine incision as determined by transvaginal ultrasound.},
  author       = {Vikhareva, Olga and Valentin, Lil},
  issn         = {1471-0528},
  keyword      = {caesarean section,caesarean scar defect,ultrasonography},
  language     = {eng},
  number       = {9},
  pages        = {1119--1126},
  publisher    = {Wiley-Blackwell},
  series       = {BJOG: An International Journal of Obstetrics & Gynaecology2000-01-01+01:00},
  title        = {Risk factors for incomplete healing of the uterine incision after caesarean section.},
  url          = {http://dx.doi.org/10.1111/j.1471-0528.2010.02631.x},
  volume       = {117},
  year         = {2010},
}