The association between gynecological complaints and the uterine sonographic features in women with a history of cesarean section.
Arch Gynecol Obstet
; 310(1): 485-491, 2024 Jul.
Article
in En
| MEDLINE
| ID: mdl-38695973
ABSTRACT
PURPOSE:
The aim of this study is to investigate the association between post-cesarean sonographic uterine measures, dysmenorrhea, and bleeding disorders.METHODS:
This is a cross-sectional study where 500 women with a history of only one cesarean section (CS) were recruited. A transvaginal transducer, GE RIC6-12-D was used for the acquisition of volumetric datasets 18 ± 7 months postpartum. Uterine length (UL), cervical length (CL), niche length (L), niche depth (D), niche width (W), fibrosis length (FL), fibrosis depth (FD), residual myometrial thickness (RMT), endometrial thickness (EM), scar to internal os distance (SO), anterior myometrial thickness superior (sAMT) and inferior (iAMT) to the scar, and the posterior myometrial thickness opposite the scar (PMT), superior (sPMT), and inferior to it (iPMT) were measured. Logistic regression with odds ratios (OR), 95% confidence intervals (CI) and ROC curves were utilized.RESULTS:
The proportion of patients with incident post-cesarean bleeding disorders and dysmenorrhoea was 36% (CI 32%, 40%) and 17% (CI 14%, 21%) respectively. Univariate logistic regression showed that only UL was associated with bleeding disorders [OR 1.04 (CI 1.01,10.7) p value 0.005], whereas dysmenorrhea was associated with RMT [OR 0.82 (CI 0.71,0.95) p value 0.008], SO [OR 0.91 (CI 0.86,0.98) p value 0.01], and RMT ratio [OR 0.98 (CI 0.97,0.99) p value 0.03]. Multivariate logistic regression for dysmenorrhoea including SO and RMT remains statistically significant with p values <0.05 and area under the curve of 0.66.CONCLUSION:
There is an association between sonographic appearance of CS scars and dysmenorrhoea. Nevertheless, the association is weak and other biological post-cesarean characteristics should be explored as potential causes.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Uterus
/
Cesarean Section
/
Ultrasonography
/
Cicatrix
/
Dysmenorrhea
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Language:
En
Journal:
Arch Gynecol Obstet
Journal subject:
GINECOLOGIA
/
OBSTETRICIA
Year:
2024
Document type:
Article
Affiliation country:
Alemania
Country of publication:
Alemania