Document Detail


Cesarean scar defect: correlation between Cesarean section number, defect size, clinical symptoms and uterine position.
MedLine Citation:
PMID:  19565535     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine the prevalence of clinical symptoms associated with Cesarean scar defects, and to determine the association between the size of these defects, clinical complaints, uterine position, and a history of multiple Cesarean sections. METHODS: In this cross-sectional study, Cesarean scar defects in women with a history of transverse lower-segment Cesarean section were measured by transvaginal ultrasound while being assessed for other gynecological conditions. The relationships between the size of the Cesarean scar defect and the clinical symptoms, uterine position and number of previous Cesarean sections were evaluated. Patients with other uterine pathologies, including endometrial hyperplasia, polyps, malignancy and submucosal myomas, were excluded from the study. RESULTS: During a 3-year period, 4250 women were assessed by transvaginal sonography, of whom 293 (6.9%) were diagnosed with Cesarean scar defects. Eighty-six patients were excluded due to other uterine pathologies. Altogether, 207 patients with Cesarean scar defects were included in this study. Women who had undergone multiple Cesarean sections tended to have larger scar defects (in width and depth) than did those who had undergone a single Cesarean section. Women with retroflexed uteri also tended to have wider defects than those with anteflexed uteri. Defect width was significantly greater in women with postmenstrual spotting, dysmenorrhea and chronic pelvic pain. CONCLUSIONS: Multiple Cesarean sections and retroflexed uteri are risk factors for larger Cesarean scar defects. The size of the Cesarean scar defect is associated with clinical symptoms such as postmenstrual spotting, dysmenorrhea and chronic pelvic pain.
Authors:
C-B Wang; W-W-C Chiu; C-Y Lee; Y-L Sun; Y-H Lin; C-J Tseng
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  34     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-06     Completed Date:  2010-08-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  85-9     Citation Subset:  IM    
Copyright Information:
(c) 2009 ISUOG.
Affiliation:
Department of Obstetrics and Gynecology, Chia Yi Chang Gung Memorial Hospital and Chang Gung University, Pu Tz City, Taiwan. brien@ms23.hinet.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Cesarean Section / adverse effects*,  methods
Cesarean Section, Repeat / adverse effects
Chronic Disease
Cicatrix / complications,  ultrasonography*
Dysmenorrhea / etiology
Female
Humans
Middle Aged
Pelvic Pain / etiology
Pregnancy
Risk Factors
Surgical Wound Dehiscence / pathology,  ultrasonography*
Uterine Diseases / complications,  ultrasonography*
Young Adult
Comments/Corrections
Comment In:
Ultrasound Obstet Gynecol. 2010 Feb;35(2):250-1; author reply 251, 251-2   [PMID:  20069682 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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