Prediction of Scar Myometrium Thickness and Previous Cesarean Scar Defect Using the Three‐Dimensional Vaginal Ultrasound

Abstract

This research aimed to explore the related factors of scar myometrial thickness and scar diverticulum formation and then predict the occurrence of uterine diverticula. 140 patients with cesarean section were selected as the research objects. According to the three-dimensional (3D) vaginal ultrasound echo and the diagnostic criteria of uterine diverticulum, the research objects were divided into a diverticulum group and a control group, with 70 cases in each group. Data such as age, number of cesarean sections, endometrial thickness, uterine position, and diverticulum size was collected, and their relationship with uterine diverticulum was compared and analyzed. The results showed that there were significant differences in menstrual days, cesarean section times, and uterine position between the two groups (P < 0.05). The height (9.02 ± 2.97), width (14.02 ± 3.08), and depth (5.14 ± 1.23) of the posterior uterine diverticula in the scar diverticulum group were all greater than the anterior uterine height (6.69 ± 1.36), the width (10.69 ± 2.15), and the depth (3.86 ± 0.69), respectively. The residual myometrium thickness in posterior position of the uterus (2.98 ± 0.75) was < anterior position of uterus (3.43 ± 0.47), and the difference was statistically significant (P < 0.05). Multivariate analysis showed that the frequency of cesarean section (1 time, 2 times), uterine position, and abnormal menstruation were independent risk factors in the scar diverticulum group (P < 0.05). In conclusion, menstrual abnormalities, the number of cesarean sections (1 time or twice), and the position of the uterus are independent risk factors for the formation of uterine scar diverticula. The deeper the diverticula, the more likely to have menstrual abnormalities, the more prone to diverticulum in patients with posterior uterus, and the deeper the diverticula in patients with 2 dissections.

Effect of humanised care on the surgical site wound infection after caesarean: A meta‐analysis

“…In obstetrics, caesarean section is one of the most common surgical procedures, a process of foetal removal via an abdominal incision through the skin, subcutaneous tissue, fat, muscle and uterine tissues of the pregnant woman's abdomen, layer by layer. 31 , 32 Caesarean section is a surgical procedure that can improve the outcome of a pregnancy, especially in cases of obstructed labour or complications of pregnancy, and can help to ensure the safety of both the mother and the newborn baby. 14 , 33 With the continuous advancements in technology, caesarean section has become the preferred method of delivery for women who are unable to have a natural birth.…”

Hidden in plain sight: role of residual myometrial thickness to predict outcome of Cesarean scar pregnancy

“…The only first-trimester sonographic finding associated with invasion was the smallest anterior myometrial thickness measured in the sagittal plane (P < 0.02), which improved the prediction of placental adherence at delivery. 3D-TVS evaluation of the RMT was also used by Shi and Du 26 . The RMT was measured successfully at the maximum depth of the anechoic dark area on the longitudinal section of the uterus.…”

“…3D‐TVS evaluation of the RMT was also used by Shi and Du 26 . The RMT was measured successfully at the maximum depth of the anechoic dark area on the longitudinal section of the uterus.…”