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Assessment of Cesarean hysterotomy scar before pregnancy and at 11–14 weeks of gestation : a prospective cohort study

Baranov, Anton LU ; Salvesen, K. LU and Vikhareva, O. LU (2017) In Ultrasound in Obstetrics and Gynecology 50(1). p.105-109
Abstract

Objective: To compare the appearance and measurement of Cesarean hysterotomy scar before pregnancy and at 11–14 weeks in a subsequent pregnancy. Methods: This was a prospective cohort study of women aged 18–35 years who had one previous Cesarean delivery (CD) at ≥ 37 weeks. Women were examined with saline contrast sonohysterography 6–9 months after CD. A scar defect was defined as large if scar thickness was ≤ 2.5 mm. Women were followed up and those who became pregnant were examined by transvaginal ultrasound at 11–14 weeks. Scar thickness was measured and scars were classified subjectively as a scar with or without a large defect. A receiver–operating characteristics curve was constructed to determine the best cut-off value for scar... (More)

Objective: To compare the appearance and measurement of Cesarean hysterotomy scar before pregnancy and at 11–14 weeks in a subsequent pregnancy. Methods: This was a prospective cohort study of women aged 18–35 years who had one previous Cesarean delivery (CD) at ≥ 37 weeks. Women were examined with saline contrast sonohysterography 6–9 months after CD. A scar defect was defined as large if scar thickness was ≤ 2.5 mm. Women were followed up and those who became pregnant were examined by transvaginal ultrasound at 11–14 weeks. Scar thickness was measured and scars were classified subjectively as a scar with or without a large defect. A receiver–operating characteristics curve was constructed to determine the best cut-off value for scar thickness to define a large scar defect at the 11–14-week scan. Results: A total of 111 women with a previous CD were scanned in the non-pregnant state and at 11–14 weeks in a subsequent pregnancy. The best cut-off value for scar thickness to define a large scar defect at 11–14 weeks was 2.85 mm, which had 90% sensitivity (18/20), 97% specificity (88/91) and 95% accuracy (106/111). In the non-pregnant state, large scar defects were found in 18 (16%) women and all were confirmed at the 11–14-week scan. In addition, a large defect was found in three women at 11–14 weeks that was not identified in the non-pregnant state. Conclusion: The appearance of the Cesarean hysterotomy scar was similar in the non-pregnant state and at 11–14 weeks in a subsequent pregnancy. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
11–14-week scan, Cesarean delivery, non-pregnant women, saline contrast sonohysterography, scar defect, ultrasonography
in
Ultrasound in Obstetrics and Gynecology
volume
50
issue
1
pages
5 pages
publisher
John Wiley & Sons
external identifiers
  • scopus:85021846957
  • wos:000404985500014
ISSN
0960-7692
DOI
10.1002/uog.16220
language
English
LU publication?
yes
id
abf0f154-9cf8-4f8a-8086-ca3aae976660
date added to LUP
2017-07-25 14:28:00
date last changed
2017-09-18 11:39:23
@article{abf0f154-9cf8-4f8a-8086-ca3aae976660,
  abstract     = {<p>Objective: To compare the appearance and measurement of Cesarean hysterotomy scar before pregnancy and at 11–14 weeks in a subsequent pregnancy. Methods: This was a prospective cohort study of women aged 18–35 years who had one previous Cesarean delivery (CD) at ≥ 37 weeks. Women were examined with saline contrast sonohysterography 6–9 months after CD. A scar defect was defined as large if scar thickness was ≤ 2.5 mm. Women were followed up and those who became pregnant were examined by transvaginal ultrasound at 11–14 weeks. Scar thickness was measured and scars were classified subjectively as a scar with or without a large defect. A receiver–operating characteristics curve was constructed to determine the best cut-off value for scar thickness to define a large scar defect at the 11–14-week scan. Results: A total of 111 women with a previous CD were scanned in the non-pregnant state and at 11–14 weeks in a subsequent pregnancy. The best cut-off value for scar thickness to define a large scar defect at 11–14 weeks was 2.85 mm, which had 90% sensitivity (18/20), 97% specificity (88/91) and 95% accuracy (106/111). In the non-pregnant state, large scar defects were found in 18 (16%) women and all were confirmed at the 11–14-week scan. In addition, a large defect was found in three women at 11–14 weeks that was not identified in the non-pregnant state. Conclusion: The appearance of the Cesarean hysterotomy scar was similar in the non-pregnant state and at 11–14 weeks in a subsequent pregnancy. Copyright © 2016 ISUOG. Published by John Wiley &amp; Sons Ltd.</p>},
  author       = {Baranov, Anton and Salvesen, K. and Vikhareva, O.},
  issn         = {0960-7692},
  keyword      = {11–14-week scan,Cesarean delivery,non-pregnant women,saline contrast sonohysterography,scar defect,ultrasonography},
  language     = {eng},
  month        = {07},
  number       = {1},
  pages        = {105--109},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in Obstetrics and Gynecology},
  title        = {Assessment of Cesarean hysterotomy scar before pregnancy and at 11–14 weeks of gestation : a prospective cohort study},
  url          = {http://dx.doi.org/10.1002/uog.16220},
  volume       = {50},
  year         = {2017},
}