Assessment of Cesarean hysterotomy scar before pregnancy and at 11–14 weeks of gestation: a prospective cohort study

Anton Baranov, K. Salvesen, O. Vikhareva

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To compare the appearance and measurement of Cesarean hysterotomy scar before pregnancy and at 11–14 weeks in a subsequent pregnancy. Methods: This was a prospective cohort study of women aged 18–35 years who had one previous Cesarean delivery (CD) at ≥ 37 weeks. Women were examined with saline contrast sonohysterography 6–9 months after CD. A scar defect was defined as large if scar thickness was ≤ 2.5 mm. Women were followed up and those who became pregnant were examined by transvaginal ultrasound at 11–14 weeks. Scar thickness was measured and scars were classified subjectively as a scar with or without a large defect. A receiver–operating characteristics curve was constructed to determine the best cut-off value for scar thickness to define a large scar defect at the 11–14-week scan. Results: A total of 111 women with a previous CD were scanned in the non-pregnant state and at 11–14 weeks in a subsequent pregnancy. The best cut-off value for scar thickness to define a large scar defect at 11–14 weeks was 2.85 mm, which had 90% sensitivity (18/20), 97% specificity (88/91) and 95% accuracy (106/111). In the non-pregnant state, large scar defects were found in 18 (16%) women and all were confirmed at the 11–14-week scan. In addition, a large defect was found in three women at 11–14 weeks that was not identified in the non-pregnant state. Conclusion: The appearance of the Cesarean hysterotomy scar was similar in the non-pregnant state and at 11–14 weeks in a subsequent pregnancy.

Original languageEnglish
Pages (from-to)105-109
Number of pages5
JournalUltrasound in Obstetrics and Gynecology
Volume50
Issue number1
DOIs
Publication statusPublished - 2017 Jul 1

Subject classification (UKÄ)

  • Obstetrics, Gynecology and Reproductive Medicine

Free keywords

  • 11–14-week scan
  • Cesarean delivery
  • non-pregnant women
  • saline contrast sonohysterography
  • scar defect
  • ultrasonography

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