[Ultrasonographic analysis of cesarean scars features in nonpregnant uterus].
OBJECTIVE
To define and assess the new ultrasonographic parameters of cesarean hysterotomy scars and to analyze their variation depending on the number of cesarean sections.


METHODS
Transvaginal ultrasound was carried out among 109 patients after cesarean section in the lower uterine segment with single-layer uterine closure. The following cesarean hysterectomy scar parameters were assessed: angle of the apex (K), basis (P) and height (W) of the anechoic triangle, the thickness of the knit tissue scar segment (G), G/P index and G/W index.


RESULTS
Transvaginal ultrasound detected the cesarean hysterectomy scar in 100% of the examined woman. In 5.5% of cases the completely knit hysterectomy scar tissue was identified. All patients from this group underwent a single cesarean section. In the remaining 94.5% of women, the ultrasound detected a presence of the anechoic triangle, defined as scar defect. No difference of statistical importance considering assessed scar parameters was observed between the groups of patients after one and two cesarean sections. The decrease of the thickness of the knit tissue scar segment (G) in the group of patients after three cesarean, sections in comparison to the group of patients after single (1.3 mm vs. 6.7 mm, p = 0.0134) and two (1.3 mm vs. 7.4 mm, p = 0.0366) abdominal deliveries, was found, as well as statistically important decrease in G/P index value in the group of patients after three cesarean sections in comparison to the patients after one (0.3 vs. 1.3, p = 0.0263) and two cesarean sections (0.3 vs. 1.2, p = 0.0138).


CONCLUSIONS
The new ultrasonographic parameters to assess the cesarean hysterectomy scar in nonpregnant uterus were introduced. Statistically important decrease in the thickness of the knit tissue scar segment (G) and G/P index value in the group of patients after three cesarean sections in comparison to the group of patients after single and two abdominal deliveries was revealed.
Zimmer
Mariusz
M
Klinika Ginekologii, Połoznictwa i Neonatologii Akademii Medycznej we Wrocławiu. mzimmer@op.pl
Pomorski
Michał
M
Fuchs
Tomasz
T
Tomiałowicz
Marek
M
Michniewicz
Joanna
J
Wiatrowski
Artur
A
Mikołajczyk
Katarzyna
K
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D009215:Myometrium / Q000000981:diagnostic imaging* / Q000473:pathology*; D011044:Poland; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging* / Q000473:pathology; D014621:Vagina / Q000000981:diagnostic imaging; D016387:Women's Health; D014945:Wound Healing