Premium
Sonographic evaluation of surgical repair of uterine cesarean scar defects
Author(s) -
Pomorski Michal,
Fuchs Tomasz,
RosnerTenerowicz Anna,
Zimmer Mariusz
Publication year - 2017
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22449
Subject(s) - medicine , dehiscence , surgery , pregnancy , ultrasound , uterine rupture , cesarean delivery , uterus , radiology , genetics , biology
Background The aim of the study was to assess the clinical outcomes of surgical repair of uterine cesarean scar defects with sonography (US). Methods Seven nonpregnant women with history of cesarean section and a large uterine scar defect were enrolled. The surgical repair was performed by minilaparotomy. The US assessment of the uterine scar was performed using a standardized approach at baseline, then at a first visit 2–3 days following the surgical intervention (V1) and at a follow‐up visit 3 months later (V2). Residual myometrial thickness (RMT), width, and depth of the scar defect were measured. Results The mean RMT increased significantly from 1.9 mm at baseline to 8.8 mm at V1 and 8.0 mm at V2. No intraoperative complications were observed. Postmenstrual spotting and abdominal pain reported preoperatively resolved after the operation. Conclusions A surgical repair procedure for an incompletely healed uterine cesarean scar is effective in increasing RMT thickness, decreasing the depth of the scar, and reducing symptoms related to the cesarean section scar defect. Further studies on post‐repair pregnancy outcomes are required to evaluate whether the procedure affects the rate of cesarean scar pregnancy, morbidly adherent placenta, and/or uterine scar dehiscence and rupture. The repair of a cesarean scar defect is recommended only for symptomatic women. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45 :455–460, 2017