Abstract
Objectives: To assess the association between ultrasonographic parameters of the Cesarean scar in non-pregnant uterus and the number of previously performed Cesarean sections. Methods: The study group included 310 non-pregnant women with a history of low transverse Cesarean section with single-layer uterine closure. The transvaginal ultrasound was performed to assess the following parameters of the Cesarean section scar: the thickness of the knit tissue scar segment (G) and in case of visualization of a triangular shaped anechoic scar defect the basis (P) and height (W) of this triangle. G/P index and G/W index values were also calculated. Results: Transvaginal sonography enabled the visualization of the Cesarean section scar in 308/310 of the examined women (99.4%). In 55/310 cases (17.7%) the completely knit hysterotomy scar tissue was identified. In the remaining group of 255/310 women (82.2%) an anechoic triangle, defined as scar defect, was observed. The mean thickness of the knit tissue scar segment (G) after single, two and three Cesarean sections was: 9.9 mm, 8.0 mm and 4.1 mm, respectively. Statistically important decrease in the G values with the number of previous performed Cesarean sections was observed. The mean G/P index values after single, two and three Cesarean sections were as follows: 1.68, 1.53 and 0.8. The mean G/W index values were: 2.8, 1.9, 0. 9, respectively. No significant difference in the G/P index values was found between patients after one and two Cesarean sections. Statistically important decrease in G/P index values in the group of patients after three Cesarean sections comparing to the patients after one (0.80 vs. 1.68, P < 0.05) and two Cesarean sections (0.8 vs. 1.53, P < 0.05) was observed. Statistically important decrease in the G/W index values was found between the groups of women after one, two and three Cesarean sections. Conclusions: The thickness of the knit tissue scar segment (G) and the G/W index values decrease with the number of previous performed Cesarean sections.
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