Dehiscence of cesarean section scar during pregnancy and delivery — risk factors

Abstract

Objective: We wanted to identify risk factors for dehiscence of cesarean section (CS) scars in patients undergoing repeated cesarean section. Material and methods: This was a retrospective case-control study over a 3-year period in our medical center (2011-2014), comparing women who had repeated CS without complications and women diagnosed with dehiscence. Data were collected from medical records and the groups were compared for demographic and obstetrical data. Results: Dehiscence was identified in 27 women, while 54 women without dehiscence were the control group. Statistically significant differences were found in the need for augmentation, the number of previous cesarean sections, cesarean section in the active phase of labor and length of hospitalization. Discussion: The need for augmentation of labor, CS in the nonactive stage and more than one cesarean section, all increased the risk of dehiscence. There was no association between dehiscence and scar pain, time elapsed since the previous cesarean section, the method of wound closure or fever.

Uterine Artery Embolization on Serum β-HCG Levels, Fertility Function and Clinical Efficacy in Patients With Cesarean Uterine Scar Pregnancy

“…The pathogenesis of CSP is not fully understood, but most scholars support the uterine incision defect theory (20,21), which states that the uterine incision site is not fully healed after lower uterine cesarean section and is defective, thus making it easy for fertilized eggs to implant in the uterine incision scar where the endometrial defect exists. It has also been shown (22,23) that the development of CSP may be closely related to the low position of the cesarean incision, multiple cesarean sections, defective suturing technique and postoperative incision healing, and wide scars. The currently accepted principles of CSP treatment (24) are early diagnosis, early termination of pregnancy and reduction of complications in order to preserve the patient's reproductive function reduce the trauma caused by surgery to the patient and achieve better outcomes.…”