Int J Gynaecol Obstet. 2021 Jun 2. doi: 10.1002/ijgo.13775. Online ahead of print.
ABSTRACT
OBJECTIVE: The aim of this study is to assess the effect of cesarean section (CS) timing, elective versus unplanned, on the residual myometrial thickness (RMT) and CS scars.
METHODS: This is a prospective single-blinded observational cohort study with 186 observations. Patients indicated to undergo first singleton CS were preoperatively recruited. Exclusion criteria are history of repeated CS, vertical hysterotomy, diabetes and additional uterine surgeries. Sonographic examination was performed for assessing the RMT ratio, the presence of a niche, fibrosis, and the distance from the scar to the internal os (SO) one year after CS. Power analysis was performed with 0.05 α, 0.1 β, and all statistical analysis was conducted with Stata® .
RESULTS: Wilcoxon rank-sum test for the association between CS timing, RMT ratio and SO showed -0.59 and -4.94 Z values (0.553, <0.001 p-values) respectively. There was no association between CS timing and niches and fibrosis (>0.99, 0.268 p-values). Linear regression between SO and the extent of cervical dilatation showed a -0.45 β (95% CI: -0.68 to -0.21) and a 10.22 mm intercept (< 0.001 p-value).
CONCLUSION: RMT is independent of the timing of cesarean section, but the SO distance shows a negative linear relationship with the cervical dilatation.
PMID:34077556 | DOI:10.1002/ijgo.13775
