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The effect of the onset of labor on the characteristics of the cesarean scar
Author(s) -
Al Naimi Ammar,
Jennewein Lukas,
Mouzakiti Niki,
Louwen Frank,
Bahlmann Franz
Publication year - 2022
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13775
Subject(s) - medicine , confidence interval , prospective cohort study , scars , surgery
Objective To assess the effect of cesarean section (CS) timing, elective versus unplanned, on the residual myometrial thickness (RMT) and CS scars. Methods This is a prospective single‐blinded observational cohort study with 186 observations. Patients indicated to undergo first singleton CS were preoperatively recruited. Exclusion criteria were history of repeated CS, vertical hysterotomy, diabetes, and additional uterine surgeries. Sonographic examination was performed for assessing the RMT ratio, the presence of a niche, fibrosis, and the distance from the scar to the internal os (SO) 1 year after CS. Power analysis was performed with 0.05 α, 0.1 β, and all statistical analyses were conducted with Stata ® . Results Wilcoxon rank‐sum test for the association between CS timing, RMT ratio and SO showed Z values of −0.59 and −4.94 ( P = 0.553 and P < 0.001), respectively. There was no association between CS timing and niches and fibrosis ( P > 0.99 and P = 0.268, respectively). Linear regression between SO and the extent of cervical dilatation showed a −0.45 β (95% confidence interval −0.68 to −0.21) and a 10.22‐mm intercept ( P < 0.001). Conclusion RMT is independent of the timing of CS, but the SO distance shows a negative linear relationship with the cervical dilatation.