The effect of the onset of labor on the characteristics of the cesarean scar

  • 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.
Author:Ammar Al Naimi, Lukas JenneweinORCiDGND, Niki Mouzakiti, Frank LouwenGND, Franz Bahlmann
Parent Title (English):International journal of gynecology & obstetrics
Place of publication:Hoboken, NJ
Document Type:Article
Date of Publication (online):2021/06/02
Date of first Publication:2021/06/02
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/04/05
Tag:cesarean section; niche; residual myometrial thickness
Issue:online version before inclusion in an issue
Page Number:5
First Page:1
Last Page:5
This study was supported by the Dr. Senckenberg Foundation, Frankfurt am Main.
Early View: Online Version before inclusion in an issue
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Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0