title: First-trimester uterine scar assessment by transvaginal ultrasound.
abstract: OBJECTIVE
  The objective of the study was to describe the assessment of lower segment uterine scar (LSCS) by transvaginal ultrasound (TVUS) during a first-trimester scan.
  
  
  METHODS
  Patients with a history of LSCS were prospectively enrolled over a 6 month period. Four groups were defined: type 1A, thin scar within cervicoisthmic canal (CIC); type 1B, thin above the internal os (IO); type 2A, dehiscent within the CIC; type 2B, dehiscent above the IO. Accuracy of first-trimester TVUS was investigated by blind testing a panel of 14 operators over a web-based dataset.
  
  
  RESULTS
  The scar was visualized in 122 of 123 patients enrolled. Types 1A, 1B, 2A, and 2B occurred in 49.2%, 3.3%, 38.3%, and 9.2%, respectively. When blind tested, fetal medicine specialists achieved a median sensitivity of 82% and specificity of 100% for the detection of a scar. These were 83% and 87% for nonspecialists.
  
  
  CONCLUSIONS
  First-trimester uterine scar assessment may become a valuable tool in early recognition of patients at risk of subsequent perinatal complications.
authors: Department of Obstetrics and Maternal-Fetal Medicine, GHU Necker-Enfants Malades, Université Paris Descartes, Paris, France.
authors: Julien J
authors: JJ
authors: Stirnemann
authors: Gihad E
authors: GE
authors: Chalouhi
authors: Sylvana
authors: S
authors: Forner
authors: Yasmine
authors: Y
authors: Saidji
authors: Laurent J
authors: LJ
authors: Salomon
authors: Jean-Pierre
authors: JP
authors: Bernard
authors: Yves
authors: Y
authors: Ville
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D002921:Cicatrix / Q000000981:diagnostic imaging* / Q000453:epidemiology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods* / Q000592:standards; D014591:Uterine Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D014599:Uterus / Q000000981:diagnostic imaging*; D014621:Vagina