Evaluation of Cesarean uterine scar by the gray-level histogram

Abstract

Evaluation of Cesarean uterine scar by the gray-level histogram Objective. To evaluate the Cesarean uterine scar by the gray-level histogram (GLH) in women with a previous Cesarean section, performed either during or before labor (elective Cesarean). MethOds. A prospective study was conducted with 40 women between 11 and 14 weeks of gestation, who were divided into three groups: 15 pregnant women with a previous elective Cesarean section(group A); 9 with a previous Cesarean section performed during labor (group B); and 16 with a single previous vaginal delivery (group C). The pregnant women were examined by transvaginal ultrasound, to obtain an image corresponding to the "shadow" formed by the uterine scar in groups A and B. In group C, GLH was accomplished in the region of the uterine isthmus. After capturing the image, the region of interest (ROI) was delimited and the option "histogram" was activated, automatically obtaining graphic representation. The mean, median and standard deviation (SD) were calculated for each study group. Means, medians and standard deviations (SD) were computed for each study group. The mean average for the control group's histogram values was the normal parameter to which other groups were compared. The ANOVA test was used to compare averages of the three groups. A (p) value of < 0.05 was considered statistically significant. Results. GLHs for group A ranged from 7 to 40.5 (mean: 24.8; SD: 11.2); from 23.1 to 47.2 (mean: 34.1; SD: 9.6) for group B, and from 21.6 to 58.8 (mean: 40.3; SD: 11.3) for group C. Conclusion. There was a significant difference for GLH in the uterine scar region of previous Cesarean sections when the surgery was elective and when performed during labor, suggesting greater tissue change in elective Cesarean sections.