Sonographic evaluation of surgical repair of uterine cesarean scar defects. Issue 8 (10th February 2017)

• Record Type: Journal Article
• Authors: Pomorski, Michal; Fuchs, Tomasz; Rosner‐Tenerowicz, Anna; Zimmer, Mariusz
• Is Part Of: Journal of clinical ultrasound. Volume 45:Issue 8(2017)
• Page Start: 455
• Page End: 460
• Publication Date: 2017-02-10
• Subjects: cesarean section -- uterine scar repair -- cesarean scar defect -- ultrasonography -- minimally invasive surgery; Ultrasonics in medicine -- Periodicals; 616.07543
• DOI: 10.1002/jcu.22449
• Languages: English
• ISSNs: 0091-2751

Abstract

ABSTRACT: Background: The aim of the study was to assess the clinical outcomes of surgical repair of uterine cesarean scar defects with sonography (US). Methods: Seven nonpregnant women with history of cesarean section and a large uterine scar defect were enrolled. The surgical repair was performed by minilaparotomy. The US assessment of the uterine scar was performed using a standardized approach at baseline, then at a first visit 2–3 days following the surgical intervention (V1) and at a follow‐up visit 3 months later (V2). Residual myometrial thickness (RMT), width, and depth of the scar defect were measured. Results: The mean RMT increased significantly from 1.9 mm at baseline to 8.8 mm at V1 and 8.0 mm at V2. No intraoperative complications were observed. Postmenstrual spotting and abdominal pain reported preoperatively resolved after the operation. Conclusions: A surgical repair procedure for an incompletely healed uterine cesarean scar is effective in increasing RMT thickness, decreasing the depth of the scar, and reducing symptoms related to the cesarean section scar defect. Further studies on post‐repair pregnancy outcomes are required to evaluate whether the procedure affects the rate of cesarean scar pregnancy, morbidly adherent placenta, and/or uterine scar dehiscence and rupture. The repair of a cesarean scar defect is recommended only for symptomatic women. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45 :455–460, 2017