Incomplete Healing of the Uterine Incision after Cesarean Section: Is It Preventable by Intraoperative Digital Dilatation of the Internal Cervical Ostium?

Abstract

Background/Aims: It was the aim of this study to determine if intraoperative digital dilatation of the closed internal cervical ostium affects the healing of the uterine scar after a cesarean section (CS). Methods: In this randomized, prospective study, 94 term pregnant patients who elected to have a CS were assigned to two groups: intraoperative digital dilatation of the internal cervical ostium (group I, n = 48) or no dilatation (group II, n = 46). Vaginal ultrasound was used to check the integrity of the cesarean scar at the uterine incision site 40–42 days after the operation. We calculated the healing ratio based on ultrasonographic results and compared the groups as to the amount of incomplete healing. Results: The frequency of abnormal scarring was significantly higher in group II (14.3 vs. 40.6%; p < 0.05). The mean healing ratio was significantly higher in group I (0.95 ± 0.12) than in group II (0.87 ± 0.1; p < 0.05). In the multiple logistic regression model, digital dilatation remained the most significant factor affecting abnormal scar formation (odds ratio = 7.7). Conclusion: Digital dilatation of a closed cervix in elective CS might lower the incidence of abnormal scarring of the uterine incision.

Cesarean scar defect: a prospective study on risk factors

“…We found 2 previous studies that recruited participants close to CD. 10,20 However, in those studies, the US examination was performed as early as 6e12 weeks after CD. We decided to perform the examinations 6 months after CD because it has been suggested that the cesarean woundhealing process will take at least 6 months.…”

Cesarean Section Scar Niche Evaluation in Non-Pregnant Women Using Three-Dimensional Ultrasound

“…We have done the examination 6 to 12 months after the CD; some other studies had performed earlier examination at 6 to 12 weeks after CD [17,18] . We preferred to do examination at this time because it was suggested that the healing process of cesarean wound takes at least 6 months [10] .…”