OP03.07: Influence of gain adjustment on three‐dimensional power Doppler indices and on STIC volumetric pulsatility indices using an in vitro model

Abstract

Objectives: The aim of the study was to evaluate uterine Cesarean scar 4–5 weeks after delivery using transvaginal ultrasound. Methods: The study group consisted of 65 women who underwent Cesarean section (CS) and reported for the transvaginal ultrasound examination 4–5 weeks after delivery. The lower uterine segment was assessed and the presence of the Cesarean scar, scar defect and defect’s dimensions were noted. The mean maternal age was 31.7 ± 4.5 years. There were 40 (61.5%) primiparas. 13 (20.0%) women had CS in the past. The mean gestational age at the delivery was 38.2 ± 2.5 weeks. Elective CS was performed in 30 (46.2%) cases. There were 27 (41.5%) operations done during delivery: 21 (32.3%) at the first stage and 6 (9.2%) at the second stage. All women had a one-layer closure of the uterine lower segment’s incison: 48 (73.8%) continous and 17 (26.2%) single sutures. Results: The scar was visible in all patients. The uterine scar defect was found in 29 (44.6%) women. In this group 5 had previous CS. The defect was present in 53.3% (16/30) of women who had elective CS compared to 37.1% (13/35) non elective CS. Continous suturing was related to the 35.3% (6/17) ratio of defects compared to 47.9% (23/48) of single sutures. The defect was found in 16/38 (55.2%) anteverted uteruses and in 13/27 (44.8%) retroverted. The uterine scar was localized ±3 mm to the level of internal os of the cervix in 26 (40%) cases, in 6 (9.2%) cases >3 mm below internal os and in 27 (41.5%) cases >3 mm above. The defect was present in 10/26 (38.5%) of scars at the level of internal os region, in 2/6 (33.3%) below internal os and in 15/27 (55.6%) above. The mean width of the defect was 8.2 ± 3.1 mm; depth 8.7 ± 4.0 mm; length 12.0 ± 5.0 mm; residual myometrial thickness was 9.8 ± 5.1 mm including 5 (7.7%) cases of RMT = 0. Conclusions: The proper healing of the uterine scar can be observed as early as 4 weeks after Cesarean section in half of women. Further research is needed to evaluate the significance of defects found in the other half of patients.