When a cesarean section scar is more than an innocent bystander in a subsequent pregnancy: Ultrasound to the rescue

Singh, Divya; Kaur, Ladbans

doi:10.1002/jcu.22485

Cited by 7 publications

(1 citation statement)

References 63 publications

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“…The increasing rate of cesarean sections is a medical concern as well as an important socioeconomic issue. Cesarean section is the most common surgery performed in women [1]. The rate of cesarean delivery was reported to be as high as 46% in China in 2010 [2] and 33.3% worldwide in 2006 [3].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopy combined with hysteroscopy for cesarean scar pregnancy

2020

Clinical and Experimental Obstetrics & Gynecology

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Section: Introductionmentioning

confidence: 99%

Laparoscopy combined with hysteroscopy for cesarean scar pregnancy

2020

Clinical and Experimental Obstetrics & Gynecology

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Prediction of Delivery Complications by First‐Trimester Ultrasound Measurement of the Gestational Sac's Distance From a Previous Cesarean Section Scar

Liu

Yang

Luo

2020

J of Ultrasound Medicine

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ObjectivesThis study was designed to investigate the clinical relationship between labor complications in the second and third trimesters and the distance from the gestational sac to a previous cesarean section (CS) scar.MethodsWe conducted a retrospective review of the electronic medical records and included all 7‐ to 9‐week transvaginal ultrasound examination reports from pregnancies with a history of a single cesarean delivery in our hospital between January 2015 and December 2017. Women were divided into 6 groups according to the distance of the gestational sac to the CS scar (groups A–F). A composite of pregnancy outcomes (gestational age at birth, delivery mode, placental abnormality, blood loss, uterine rupture, and hysterectomy) and other maternal and neonatal outcomes were assessed.ResultsA total of 699 cases were included in our study. The median gestational age was 39.0 (range, 38.1–39.9) weeks. The median intrapartum blood loss volume was 400 (range, 300–500) mL. The results showed no statistically significant difference in blood loss (P = .297) or birth weight of the neonate (P = .318) among the distance subgroups. Overall, the fetuses were stillborn in 9 of 699 cases (1.29%). There was a statistically significant difference in a morbidly adherent placenta, placenta previa, and preterm labor, and their incidence increased with decreasing distance (P < .001; P for trend < .05). There was no statistically significant difference in uterine rupture (P = .597) or the delivery mode (P = .187) among the subgroups.ConclusionsThe relative positions of a CS scar and the gestational sac in the first trimester are associated with the incidence of placental abnormalities. As the distance decreases, the extent of a morbidly adherent placenta increases.

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