| Changes in Cesarean section scar dimensions during pregnancy: a prospective longitudinal study. | |
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MedLine Citation:
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PMID: 23108803 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Objectives: To describe the changes in cesarean section (CS) scars longitudinally throughout pregnancy, and relate initial scar measurements, demographic and obstetric variables to subsequent changes in scar features and the final pregnancy outcome. Methods: In this prospective observational study we used transvaginal sonography (TVS) to examine the CS scar of 320 consecutive pregnant women at 11-13, 19-21 and 32-34 weeks gestation. Visible scars consisted of hypoechoic shadow and residual myometrial thickness (RMT) segments. The hypoechoic segment was measured in three dimensions. Analyses were carried out using one-way repeated measures ANOVA and mixed modeling tests. The incidence of subsequent scar rupture was recorded. Results: The scar was visible in 284/320 cases (89%). For both scar segments, the larger the initial scar size, the more the scar decreased in size during pregnancy. For the hypoechoic segment, scar width on average increased by 1.8mm per trimester in 98% of cases, while scar depth and scar length decreased by 1.8 and 1.9mm in 97 and 99% of cases respectively (FDR p-value <0.0001>. The mean RMT segment was 3.6mm and on average decreased by 1.1mm in 98% of the cases. Two cases <0.62%> of uterine scar rupture were confirmed, these had a mean RMT of 0.5mm and average decrease in RMT of 2.6mm over the course of pregnancy. Conclusion: Our study establishes reference data and confirms that CS scars change in dimension throughout pregnancy. Scar rupture was associated with a smaller RMT and greater decrease in RMT during pregnancy. The absolute value and changes seen in CS scars have the potential to be tested as predictors of uterine scar rupture and performance in trials of VBAC. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. |
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Authors:
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O Naji; A Daemen; A Smith; Y Abdallah; S Saso; C Stalder; A Sayasneh; A McIndoe; S Ghaem-Maghami; D Timmerman; T Bourne |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-25 |
Journal Detail:
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Title: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Volume: - ISSN: 1469-0705 ISO Abbreviation: Ultrasound Obstet Gynecol Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9108340 Medline TA: Ultrasound Obstet Gynecol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. |
Affiliation:
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Obstetrics and Gynecology Unit, Queen Charlottes and Chelsea Hospital, Imperial College, London, UK; Institute of Reproductive and Developmental Biology, Imperial College London, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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