The Prevalence and Risk Predictors of Cesarean Scar Defect at Six Weeks Postpartum
Keywords:
Cesarean section, Uterine niche, cesarean scar defectAbstract
Background: Cesarean scar defect following cesarean section is an emerging condition that can have long-term implications for maternal health, particularly abnormal vaginal bleeding, cesarean scar pregnancy, and other complications that may arise during future pregnancies.
Objectives: To determine the prevalence of uterine niche following cesarean section at 6 weeks postpartum and to analyze factors potentially associated with the development of uterine niche.
Materials and Methods: This descriptive prospective cohort study was conducted at Vachira Phuket Hospital from April 15, 2024, to November 15, 2024. The study population included healthy, singleton pregnant women aged 18 years or older who underwent cesarean delivery. Participants were assessed for uterine niche using ultrasound at 6 weeks postpartum.
Results: Among 101 participants, the prevalence of uterine niche was 74.3% (75/101), with 38.7% (29/75) of these cases classified as large niches. The study found that anteverted uterus was significantly associated with the development of uterine niche, increasing the risk by 18-fold (adjusted OR = 18.00, 95% CI = 4.17 – 77.77, p < 0.001). Additionally, women under 35 years of age had a 6.19-fold increased risk of developing large uterine niches (adjusted OR = 6.19, 95% CI = 1.59 – 24.09, p = 0.009).
Conclusions: The prevalence of uterine niche in postpartum patients at Vachira Phuket Hospital was 74.3%, highlighting the importance of monitoring this condition, particularly in cases of anteverted uterus. Additional ultrasound evaluation is recommended to confirm the presence of uterine niche, monitor symptoms, assess potential complications, and evaluate healing progress over a 6-month period.
References
Betran AP, Ye J, Moller AB, et al. The Increasing trend in cesarean section rates: global, regional and national estimates: 1990- 2014. PLoS One 2016;11:e0148343.
Allornuvor G, Xue M, Zhu X, Xu D. The definition, aetiology, presentation, diagnosis and management of previous cesarean scar defects. J Obstet Gynaecol. 2013;33(8):759-63.
Tulandi T, Cohen A. Emerging manifestations of cesarean scar defect in reproductive-aged women. J Minim Invasive Gynecol. 2016;23(6):893-902.
Pomorski M, Fuchs T, Zimmer M. Prediction of uterine dehiscence using ultrasonographic parameters of cesarean section scar in the nonpregnant uterus: a prospective observational study. BMC pregnancy Childbirth. 2014;14:365-71.
Timor-Tritsch IE, Monteagudo A, Cali G, et al. Cesarean scar pregnancy is a precursor of morbidly adherent placenta. Ultrasound Obstet Gynecol. 2014;44(3):346-53.
van der Voet LF, Bij de Vaate AM, Veersema S, Brolmann HA, Huirne JA. Long-term complications of caesarean section. The niche in the scar: a prospective cohort study on niche prevalence and its relation to abnormal uterine bleeding. BJOG. 2014; 121: 236-44.
Pan H, Zeng M, Xu T, et al. The prevalence and risk predictors of cesarean scar defect at 6 weeks postpartum in Shanghai, China : A Prospective cohort study. Acta Obstet Gynecol Scand 2019;98:413-22.
Antila-Langsjo RM, Maenpaa JU, Huhtala, et al. Cesarean scar defect: a prospective study on risk factors, Am J Obstet Gynecol2018;219:458.e1-8.
Nitayaphan N, Laosooksathit W, Kongsomboon K, Kitporntheranunt M. Prevalence of and Factors Associated with Large Cesarean Scar Defects in Women at Six Weeks Postpartum. Thai J Obstet Gynaecol2023;31(5):350-8.
Osser OV, Jokubkiene L, Valentin L. High prevalence of defects in Cesarean section scars at transvaginal ultrasound examination. Ultrasound Obstet Gynecol2009;34:90-7
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใด ๆ
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นลิขสิทธิ์ของมหาราชนครศรีธรรมราชเวชสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากวารสารมหาราชนครศรีธรรมราชเวชสาร ก่อนเท่านั้น
