Does the appearance of the cutaneous scar after cesarean section reflect the residual myometrial thickness?

Abstract

Purpose The aim of this study is to utilize the Manchester scar scale (MSS) and ultrasound in investigating the association between uterine wall defects and cutaneous scar characteristics after cesarean section (CS). Methods This is a prospective cohort study. The degree of myometrial loss was quantified by calculating a residual myometrial thickness (RMT) ratio as a percentage of RMT to the pre-cesarean anterior uterine wall thickness. Cutaneous scar assessment was performed according to the MSS. Spearman’s correlation and the Kruskal–Wallis test with a cut-off value of p < 0.05 were used for statistical analysis. Results Two hundred forty seven women, of which 2.4% had an Asian, 3.6% an Afro-American, 82% a Caucasian and 12% a Mediterranean background, were recruited. The RMT ratio ranged between 11.9 and 100% with a median of 55.8% and an average of 56%. MSS scores ranged from 4 to 13 with a median of 5 and an average of 6. Spearman’s correlation between MSS and RMT ratio show a rho of − 0.01 with a p value of 0.8. The correlation between MSS and RMT ratio within the four ethnical groups showed a p value between 0.3 and 0.8 and a rho between 0.8 and − 0.8. The Kruskal–Wallis test showed an eta2 of 0.13 and a p value of 0.0002 for the effect of ethnicity on MSS and an eta2 of 0.009 and a p value of 0.68 for the effect of ethnicity on the RMT ratio. Conclusion CS laparotomy scars heal differently between ethnical groups, but generally with satisfying results. Ethnicity does not affect myometrial healing and scar appearance does not reflect myometrial healing after CS. Thus, separate uterine sonographic assessment is recommended.

RETRACTED: Meta‐analysis comparing different ultrasound detection methods to accurately assess wound healing and scar formation after caesarean section

“…6,7 Despite their widespread use, the literature presents a gap in comparative analysis and systematic evaluation of CAU and TVU's efficacy in assessing wound healing post-C-section in twin pregnancies. 8 This meta-analysis aims to fill this gap by systematically reviewing and analysing studies that compare the effectiveness of these two ultrasonography techniques in detecting wound healing stages and identifying potential complications early in the postoperative period. 8,9 This research is significant, as it addresses a critical aspect of post-C-section care in a high-risk group.…”

“…8 This meta-analysis aims to fill this gap by systematically reviewing and analysing studies that compare the effectiveness of these two ultrasonography techniques in detecting wound healing stages and identifying potential complications early in the postoperative period. 8,9 This research is significant, as it addresses a critical aspect of post-C-section care in a high-risk group. By delineating the relative strengths and limitations of CAU and TVU in monitoring wound healing, the study seeks to inform best practices and enhance postoperative management strategies for women undergoing caesarean deliveries in twin pregnancies.…”

“… 8 This meta‐analysis aims to fill this gap by systematically reviewing and analysing studies that compare the effectiveness of these two ultrasonography techniques in detecting wound healing stages and identifying potential complications early in the postoperative period. 8 , 9 …”

Dehiscence of Uterine Hysteroraphy After Caesarian Section Associated with Secondary Anemia, Subaponevrotic Hematoma or Dehiscence of Skin Wound

“…(4,5) Several studies have shown an association 1 Faculty of Medicine, "Ovidius" University, Constanta, Romania 2 Constanta County Emergency Hospital, Constanta, Romania between these uterine parietal defects and gynecological symptoms in women who have had at least one cesarean delivery, symptoms that include either intermenstrual spotting, chronic pelvic pain, or their association. (6,7) This study aims to show whether anemia, postoperative hematoma, and cutaneous wound dehiscence have a connection in performing postoperative hysterectomies after caesarean births.…”