OC133: High prevalence of defects in caesarean section scars at transvaginal ultrasound examination

Osser, O. Vikhareva; Jokubkiene, L.; Valentin, Lil

doi:10.1002/uog.5541

Cited by 2 publications

(4 citation statements)

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“…Vikhareva Osser et al observed more scar defects in women with a uterus in retroflexion. 9 A higher incidence of uterine position in retroflexion and defects was only seen in our study in the 6-week control in the SLT group.…”

Section: Discussioncontrasting

confidence: 56%

“…We observed a higher prevalence of defects compared with other groups after first CS (37-61%). 3,9,10,12 The discrepancy is most likely to be explained not only by the different definitions of defect that have been used in different studies, but also by including defects that were not in contact with the uterine cavity. The 12-month prevalence of more serious defects (RMT <2.5 mm) 9,13,14 in contact with the cavity was 12.2% in the SLT and 6.8% in the DLT group.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7] Transvaginal ultrasound is validated tool to evaluate uterine scar defects commonly referred to as "niche". 8,9 Healing and scar maturation are influenced by the suture technique, number of previous CS deliveries and patient's medical and obstetric history. 10 There are many techniques for the closure of the uterine incision.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound cesarean scar assessment one year postpartum in relation to one‐ or two‐layer uterine suture closure

Hanacek

Vojtĕch

Urbánková

et al. 2019

Acta Obstet Gynecol Scand

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Introduction: This study compared healing of the scars after cesarean section during the first postpartum year using a single-or double-layer suturing technique. Scarring was assessed by a transvaginal ultrasound. We explored the appearance and localization of uterine scars with regard to the obstetric history. Our aim was to compare the position of the scar or defect, if present, its dimensions, and any residual myometrium with respect to the suturing technique during the cesarean section.Material and methods: Women with uncomplicated singleton pregnancies indicated for elective or acute cesarean section were randomly allocated to the uterine closure technique group. During the first postpartum year, their lower uterine segment was examined with a transvaginal ultrasound in three consecutive visits at 6 weeks, 6 months and 12 months.Results: 324 women attended the 12-month visit; of these, 149 underwent single-layer closure of the uterine incision and 175 double-layer technique. A higher proportion of the defects is seen in the single-layer closure technique of suturing. Defects in the single-layer group were wider (0.002) and the residual myometrial thickness in the singlelayer group were thinner (0.019). Women who underwent cesarean section at the stage of full cervical dilation had scars that were closer to the external cervical os (0.000). The position of the uterus varies greatly between controls (0.000). The combination of uterine position and scar defect presence changed significantly between controls (0.001), and was significantly dependent on the suturing method (0.003). Defects with or without contact with the uterine cavity changed statistically between controls (0.017). Both types of defects were more common in the single-layer closure technique group. Conclusions:The findings of this study demonstrate that double-layer technique with the first continuous nonlocking suture followed by a second continuous nonlocking suture is associated with better suture healing and greater residual myometrialThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

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Ultrasound cesarean scar assessment one year postpartum in relation to one‐ or two‐layer uterine suture closure

Hanacek

Vojtĕch

Urbánková

et al. 2019

Acta Obstet Gynecol Scand

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“…CS scar defect (CSD) is a wedge-shaped distortion at the uterine incision site; this well-known phenomenon has been reported using radiologic, endoscopic, and histologic methods [3]. CSD, also known as a niche, an isthmocele, or Cesarean scar dehiscence, has been implicated as an etiologic factor in clinical problems, such as rupture of the uterus during a subsequent pregnancy, ectopic pregnancy at the Cesarean delivery scar, Cesarean scar endometriosis, secondary infertility, postmenstrual spotting, and dysmenorrhea [4,5].…”

Section: Introductionmentioning

confidence: 99%

Hydrosonographic Assessment of the Effect of Two Different Suture Materials on Healing of the Uterine Scar after Cesarean Delivery: A Prospective Randomized Controlled Trial

Şevket

Takmaz

Özcan

et al. 2020

Z Geburtshilfe Neonatol

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Purpose This study aimed to compare the effects of two different suture materials, monofilament synthetic absorbable sutures versus multifilament synthetic absorbable sutures, on healing the uterine scar after a cesarean delivery. Methods A total of 95 women between the ages of 18 and 40 who had undergone a primary cesarean section (CS) after the 38th week of gestation. In Group I (n=48), continuous double-layer unlocked closure of the low transverse uterine incision was performed using monofilament synthetic absorbable sutures. In Group II (n=47), continuous double-layer unlocked closure of the low transverse uterine incision was performed using multifilament synthetic absorbable sutures. Six months after the operation, the integrity of the cesarean scar at the uterine incision site was assessed using hydrosonography. The healing ratio and the thickness of the residual myometrium covering the defect were calculated as markers of uterine scar healing. Results No statistically significant differences were observed between the groups with regard to the preoperative hemoglobin concentrations, the change in the hemoglobin concentrations, operating time, and the number of intraoperative additional hemostatic uterine sutures. Mean thickness of the residual myometrium covering the defect was thicker in the monofilament suture group in comparison to the multifilament suture group (7.76±2.11 vs. 5.96±1.69, respectively; p<0.01). The mean healing ratio was significantly higher in the monofilament suture group in comparison to the multifilament suture group (0.76±0.13 vs. 0.60±0.12, respectively; p<0.01) Conclusion Continuous double-layer unlocked closure of the uterine incision at cesarean delivery using monofilament synthetic absorbable sutures decreases the risk of CS scar defect.

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OC133: High prevalence of defects in caesarean section scars at transvaginal ultrasound examination

Cited by 2 publications

References 0 publications

Ultrasound cesarean scar assessment one year postpartum in relation to one‐ or two‐layer uterine suture closure

Ultrasound cesarean scar assessment one year postpartum in relation to one‐ or two‐layer uterine suture closure

Hydrosonographic Assessment of the Effect of Two Different Suture Materials on Healing of the Uterine Scar after Cesarean Delivery: A Prospective Randomized Controlled Trial

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