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Clinical importance of appearance of cesarean hysterotomy scar at transvaginal ultrasonography in nonpregnant women.

Vikhareva, Olga LU and Valentin, Lil LU (2011) In Obstetrics and Gynecology 117(3). p.525-532
Abstract
OBJECTIVE: To estimate the association between the appearance of cesarean hysterotomy scars at transvaginal ultrasound examination of nonpregnant women and the outcome of subsequent pregnancies and deliveries. METHODS: A total of 162 women who had ever given birth by cesarean underwent transvaginal ultrasound examination of the hysterotomy scar 6 to 9 months after the latest cesarean delivery. Published ultrasound definitions of large scar defects were used. The appearance of the hysterotomy scar at ultrasound examination was compared with the outcome of subsequent pregnancies and deliveries. Clinical information on subsequent pregnancies was obtained from medical records. RESULTS: Six women were lost to follow-up, leaving 156 for... (More)
OBJECTIVE: To estimate the association between the appearance of cesarean hysterotomy scars at transvaginal ultrasound examination of nonpregnant women and the outcome of subsequent pregnancies and deliveries. METHODS: A total of 162 women who had ever given birth by cesarean underwent transvaginal ultrasound examination of the hysterotomy scar 6 to 9 months after the latest cesarean delivery. Published ultrasound definitions of large scar defects were used. The appearance of the hysterotomy scar at ultrasound examination was compared with the outcome of subsequent pregnancies and deliveries. Clinical information on subsequent pregnancies was obtained from medical records. RESULTS: Six women were lost to follow-up, leaving 156 for analysis. Of these 156 women, 69 became pregnant after the ultrasound examination (99 pregnancies, 65 deliveries). There were no placental complications or scar pregnancies. At the first repeat cesarean delivery after the ultrasound examination, 5.3% (1/19) of the women with an intact scar or a small scar defect had uterine dehiscence or rupture compared with 42.9% (3/7) of those with a large defect (P=.047), odds ratio 11.8 (95% confidence interval 0.7-746). CONCLUSION: Our results point toward a likely association between large defects in the hysterotomy scar after cesarean delivery detected by transvaginal ultrasonography in nonpregnant women and uterine rupture or dehiscence in subsequent pregnancy. (Obstet Gynecol 2011;117:525-32) DOI:10.1097/AOG.0b013e318209abf0 (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Obstetrics and Gynecology
volume
117
issue
3
pages
525 - 532
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000287649400003
  • pmid:21343754
  • scopus:79952018825
ISSN
1873-233X
DOI
10.1097/AOG.0b013e318209abf0
language
English
LU publication?
yes
id
ab305d93-baad-470b-95e4-d83cb59420b3 (old id 1831541)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21343754?dopt=Abstract
date added to LUP
2011-03-01 17:46:02
date last changed
2017-10-22 04:06:42
@article{ab305d93-baad-470b-95e4-d83cb59420b3,
  abstract     = {OBJECTIVE: To estimate the association between the appearance of cesarean hysterotomy scars at transvaginal ultrasound examination of nonpregnant women and the outcome of subsequent pregnancies and deliveries. METHODS: A total of 162 women who had ever given birth by cesarean underwent transvaginal ultrasound examination of the hysterotomy scar 6 to 9 months after the latest cesarean delivery. Published ultrasound definitions of large scar defects were used. The appearance of the hysterotomy scar at ultrasound examination was compared with the outcome of subsequent pregnancies and deliveries. Clinical information on subsequent pregnancies was obtained from medical records. RESULTS: Six women were lost to follow-up, leaving 156 for analysis. Of these 156 women, 69 became pregnant after the ultrasound examination (99 pregnancies, 65 deliveries). There were no placental complications or scar pregnancies. At the first repeat cesarean delivery after the ultrasound examination, 5.3% (1/19) of the women with an intact scar or a small scar defect had uterine dehiscence or rupture compared with 42.9% (3/7) of those with a large defect (P=.047), odds ratio 11.8 (95% confidence interval 0.7-746). CONCLUSION: Our results point toward a likely association between large defects in the hysterotomy scar after cesarean delivery detected by transvaginal ultrasonography in nonpregnant women and uterine rupture or dehiscence in subsequent pregnancy. (Obstet Gynecol 2011;117:525-32) DOI:10.1097/AOG.0b013e318209abf0},
  author       = {Vikhareva, Olga and Valentin, Lil},
  issn         = {1873-233X},
  language     = {eng},
  number       = {3},
  pages        = {525--532},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Obstetrics and Gynecology},
  title        = {Clinical importance of appearance of cesarean hysterotomy scar at transvaginal ultrasonography in nonpregnant women.},
  url          = {http://dx.doi.org/10.1097/AOG.0b013e318209abf0},
  volume       = {117},
  year         = {2011},
}