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. Conclusions Caesarean in advanced labour is associated with increased risk of incomplete healing of the uterine incision as determined by transvaginal ultrasound.

Objectives 23% (10/43) and 45% (5/11) (P = 0.027), and at least one total defect was seen in 6% (7/108), 7% (3/43) and 18% (2/11) (P = 0.336). In women who had undergone one Cesarean section, the median distance between an intact scar and the internal cervical os was 4.6 (range, 0-19)

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.

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Despite clear evidence that there is overrepresentation of male fetal sex in cases with placental abruption, prior studies have not investigated possible differential outcomes between female and male infants following abruption.This population-based case-control study investigated possible sex-related differences in short-term morbidity in cases with placental abruption. Data on pregnancy, delivery, and perinatal outcomes were collected from the Finnish Hospital Discharge Register and the Medical Birth Register for all women with a diagnosis of placental abruption between 1987 and 2005. A total of 4081 women with singleton pregnancy and placental abruption were matched with 12,752 controls without placental abruption by maternal age, parity, year of birth, and hospital district area. The final analysis included 3688 cases and 12,695 controls with live-born infants. The primary study outcome measure was placental abruption.There was a significant male sex overrepresentation in the placental abruption cases compared with the controls (cases: 0.548 vs. controls: 0.516, P ϭ 0.001). Male fetuses in the placental abruption group were born earlier than female fetuses (P ϭ 0.018).Cases were born earlier than the controls, and were also associated with lower birth weight, more frequent growth restriction, as well as lower Apgar scores and pH values (all comparisons, P Ͻ 0.001). Compared with controls, newborn infants in the abruption group more often needed special care, respirator treatment, intravenous antimicrobials, and phototherapy (all comparisons, P Ͻ 0.001). No difference occurred in perinatal outcomes between female and male infants in the placental abruption group.These findings show that placental abruption was more common and occurred earlier in pregnancy with male fetal sex compared with females but other short-term outcomes of the newborns were similar. Outcomes of newborns in the placental abruption group were worse compared with controls. ABSTRACTThere is a black-white disparity in birth outcomes. The risk of a low birth weight (LBW) infant and infant death is about twice more likely among African-American women than among non-Hispanic white women. Several studies have demonstrated worsening birth outcomes with increasing maternal age in African-American women; this phenomenon has been referred to as "weathering." Some investigators have suggested that weathering may result from the cumulative effect of socioeconomic disadvantages on the health of African-American women. Prior studies reported more frequent occurrence of weathering among African-American mothers living in low-income neighborhoods during pregnancy, even after adjustment for maternal health characteristics. There are little data on the effect of early life environment on weathering.The present study tested the hypothesis that African-American women who had never been exposed to poverty in low-income areas would not experience weathering, and that white women exposed to poverty throughout their life would show evidence of weathering. Data obt...

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