Association between deficient cesarean delivery scar and cesarean scar syndrome

被引:17
作者
Dosedla, Erik [1 ]
Gal, Peter [2 ]
Calda, Pavel [3 ,4 ]
机构
[1] Univ Pavol Jozef Safarik Kosice, Hosp AGEL Kosice Saca Inc, Dept Obstet & Gynecol, Kosice 04015, Slovakia
[2] Univ Pavol Jozef Safarik Kosice, Fac Med, Ctr Clin & Preclin Res MEDIPK, Kosice 04001, Slovakia
[3] Charles Univ Prague, Fac Med 1, Dept Gynecol & Obstet, Apolinarska 18, Prague 12851 2, Czech Republic
[4] Gen Teaching Hosp, Apolinarska 18, Prague 12851 2, Czech Republic
关键词
cesarean delivery; cesarean delivery scar; cesarean scar syndrome; scar defect; ultrasound; SECTION SCARS; MATERNAL MORBIDITY; UTERINE SCAR; PREVALENCE; ULTRASOUND; PREGNANCY; DIAGNOSIS; SYMPTOMS; HISTORY; NICHE;
D O I
10.1002/jcu.22911
中图分类号
O42 [声学];
学科分类号
070206 ; 082403 ;
摘要
Introduction The aim of our study was to compare long-term morbidity after elective and emergency cesarean delivery (CD). Methods A prospective cohort study was conducted in 200 women delivered by CD. Ultrasound examinations were performed transvaginally at 6 weeks and 18 months after CD. Clinical data were collected at the time of CD and after 18 months. Results In the group of 200 women, 29% underwent emergency and 71% elective CD. Then, 6 weeks and 18 months after CD, a severe scar defect was present in 7% and 5%, respectively (P= .4). After 18 months of CD, 17% (34/200) of women had evidence of adhesions of the vesicouterine pouch. Severe CD scar defects were significant predictors for adhesion formation in vesicouterine pouch (OR 3.14, 95% CI, 1.54-4.74), pelvic pain (OR 1.68, 95% CI, 0.22-3.14), dysmenorrhea (OR 2.12, 95% CI, 0.74-3.50), and dyspareunia (OR 1.38, 95% CI, 0.09-2.67). Uterine scar defects detected at 6 weeks after elective CD were detectable at 18 months in only 40% of cases, whereas uterine scar defects after emergency CD were still detectable in 87% of cases. Conclusion Uterine scar defects are more frequent at 18 weeks after emergency CD, than after elective CD (40% vs 87%). Women with severe scar defects have higher risk of adhesion formation, dysmenorrhea, dyspareunia, and chronic pelvic pain.
引用
收藏
页码:538 / 543
页数:6
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