The correlation between histopathological and ultrasound findings regarding Cesarean section scars – A three-year survey study

Abstract

The cesarean operation represents a major surgery, with a higher risk of postoperative complications and longer postoperative recovery than vaginal delivery.Due to the increasing frequency of cesarean sections, the ultrasound imaging of the uterine scar has become a particularly useful tool in identifying its potential long-term complications. This should be done pre-conceptively and quarterly or whenever necessary during pregnancy.Currently, there are only few histopathological studies on the uterine scar, trying to assess the myometrial repair and certain factors that influence the quality of the scar.The study was performed on a batch of 123 patients with previous C-sections, with multiple ultrasound exams during pregnancy and post-operative pathologic evaluation of the uterine scar in order to assess the possibility of a new prognostic score by correlating these two factors.Our study found solid evidence related to possible correlations between histopathological and ultrasound data on the cesarean section scar, which could lead to a possible predictive algorithm with implications for both prognostic and therapeutic fields. Keywords ultrasound, histopathological aspects, cesarean scar. Highlights The predictive ultrasound parameters for the risk of rupture/dehiscence of the uterine scar showed varying cut-off values, ranging between 2.0 and 3.5 mm for the lower segment and up to 0.97 mm for the myometrium. This observation of inverse proportionality between the uterine thickness and the risk of rupture/dehiscence of the scar seems to be correlated with the histopathological features of the cesarean section scar.