title: Association of uterine wall thickness with pregnancy outcome following uterine-sparing surgery for diffuse uterine adenomyosis.
abstract: BACKGROUND
  The risk of uterine rupture is a major concern for women who become pregnant after undergoing an adenomyomectomy.
  
  
  OBJECTIVE
  The aim of this study was to investigate the association of uterine wall thickness with pregnancy outcome.
  
  
  METHODS
  Uterine wall thickness was measured using sonography and/or magnetic resonance imaging in 23 pregnant women who underwent uterine-sparing surgery for diffuse uterine adenomyosis prior to conception.
  
  
  RESULTS
  Of the 23 women, 10 (43.5%) had an early miscarriage and 13 (56.5%) proceeded to delivery. Of the ten early miscarriage cases, two had a uterine rupture caused by excision of the uterine wall to within 7 mm.
  
  
  CONCLUSIONS
  Wall thickness of the excised uterus was highly associated with uterine rupture. We concluded that optimum wall thickness for conception and preventing uterine rupture during pregnancy may range from 9 to 15 mm.
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Ibaraki, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Otsubo
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Ibaraki, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Nishida
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Ibaraki, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Arai
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Ibaraki, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Ichikawa
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Akiyo
authors.initials: A
authors.lastname: Taneichi
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Ibaraki, Japan.
authors.forename: Miyako
authors.initials: M
authors.lastname: Sakanaka
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology*; D062788:Adenomyosis / Q000473:pathology / Q000601:surgery*; D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008279:Magnetic Resonance Imaging; D011183:Postoperative Complications / Q000209:etiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D016216:Ultrasonography, Prenatal; D014597:Uterine Rupture / Q000209:etiology*; D014599:Uterus / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery
keywords: adenomyosis; conservative surgery; ultrasonography