1711 Cesarean Scar Defect: Risk Factors and Comparison of Evaluation Efficacy between Transvaginal Sonography and Magnetic Resonance Imaging

Abstract

Study Objective The aim of this study is to determine the risk factors for development of cesarean scar defect (CSD), to compare the efficacy of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) for CSD assessment, further to investigate the association between CSD size and clinical symptoms. Design A retrospective cohort study Setting Obstetrics and Gynecology Hospital of Fudan University Patients or Participants A total of 189 CSD patients and 378 non-CSD women with a history of cesarean section (CS) in Obsterics and Gynecology Hospital of Fudan University from January 2008 to February 2016 were enrolled. Interventions All patients were diagnosed as CSD by TVS and/or MRI. Measurements and Main Results The potential risk factors for CSD were investigated with multivariable logistic regression analysis. The TVS and MRI were performed for CSD measurements, including residual myometrium thickness, depth, length and width of CSD. The association between CSD size through TVS/MRI and symptoms were evaluated respectively. The operation time of CS ≥85min, peripartum fever or infection, retroflexed uterine were risk factors for CSD. And age at time of last CS Conclusion Multi-factors contribute to development of CSD. Prevention of peripartum infection, shortening operation time, reducing blood loos and a more careful uterine closure are needed to decrease the risk of developing CSD. MRI is a reliable method for diagnosis and measurement of CSD and can be utilized in clinical practice.