Ultrasonography of the uterus within 6 weeks following Cesarean section

Abstract

Objective. The aim of the study was to compare the integrity of the uterine scar after elective and urgent Caesarean section (CS) and specify a technique to describe the sonographic fndings. Methods. Ultrasound examination was performed in 131 women at 48 and 96 hours (transabdominal), and 6 weeks (transvaginal) after CS. We assessed numerous clinical and ultrasound variables. To quantify the severity of the scar defect, we describe a "dehiscence risk coeffcient" (DRC). Results. Mean myometrial thickness above the scar and below the scar 6 weeks after CS was 12.1 ± 2.5 mm and 11.5 ± 2.5 mm, respectively. The mean scar thickness after elective and urgent CS was 7.68 ± 2.27 mm and 4.9 mm ± 2.21 mm, respectively. The cut-off value (5 th percentile) for the CS scar thickness and for DRC was 2.9 mm and 0.25, respectively. DRC less than 0.25 was elected to consider a severe scar defect, which was diagnosed in 14/131 (10.7%) patients, 1.5% after elective CS and 9.2% after urgent CS. (P < 0.001). Conclusions. Dehiscence risk coeffcient measurement six weeks after delivery allows for precise quantitative description of the CS scar. Urgent CS has a higher risk for a severe scar defect. © Versita Sp. z o.o.