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Association between deficient cesarean delivery scar and cesarean scar syndrome
Author(s) -
Dosedla Erik,
Gál Peter,
Calda Pavel
Publication year - 2020
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.22911
Subject(s) - medicine , pelvic pain , adhesion , cesarean delivery , surgery , prospective cohort study , obstetrics , uterus , gynecology , pregnancy , chemistry , organic chemistry , biology , genetics
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.