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

Vikhareva, Olga LU and Valentin, Lil LU orcid (2010) In BJOG: An International Journal of Obstetrics & Gynaecology 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)
Please use this url to cite or link to this publication:
author
and
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 & Gynaecology
volume
117
issue
9
pages
1119 - 1126
publisher
Wiley-Blackwell
external identifiers
  • wos:000279532500012
  • pmid:20604776
  • scopus:77954396592
  • pmid:20604776
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
2016-04-01 10:26:12
date last changed
2022-04-27 21:57:23
@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}},
  keywords     = {{caesarean section; caesarean scar defect; ultrasonography}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{1119--1126}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{BJOG: An International Journal of Obstetrics & Gynaecology}},
  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}},
  doi          = {{10.1111/j.1471-0528.2010.02631.x}},
  volume       = {{117}},
  year         = {{2010}},
}