Relationship of Interpregnancy Interval with Ultrasonographic Measurement of Lower Uterine Segment Caesarean Scar Thickness

Background The possible impact of interpregnancy interval (IPI) on perinatal outcomes has long been studied, however, a definition of the optimal interval is still not clear. Both short and long IPIs have been associated with obstetrical syndromes and short and long-term complications. In this study, we sought to explore the impact of IPI on the hazard for neoplasm of the offspring, thus contribute to the present literature in determining the preferred birth spacing. Objective We aim to investigate the association between short and long IPIs and the hazard for childhood neoplasm of the offspring. Methods A population-based retrospective cohort analysis comparing offspring neoplasm hazard following three different IPIs. Exposure was defined as short (<6 months), or long (>60 months) IPIs, whereas intermediate IPI (6 months − 60 months) served as the comparison group. The study included singleton live births in a tertiary regional hospital between 1991 and 2014. Offspring were followed for 18 years, and all hospitalization records for neoplasm diagnoses were collected. Kaplan–Meier survival curves were used for the cumulative incidence of neoplasm morbidity, and Cox proportional hazards models were used to control for confounders. Results During the study period, 144,397 deliveries met the inclusion criteria. Of those, 18,947 (13.1%) occurred in women with short IPI, 114,012 (79%) in women with intermediate IPI, and 11,438 (7.9%) in women with long IPI. 61 benign neoplasms and 80 malignant neoplasms were registered in offspring born after long IPI. The total percentage of neoplasm were the highest in the long IPI group versus the intermediate and short IPI groups (malignant − 0.7%, 0.6%, 0.5% respectively, benign − 0.5%, 0.4%, 0.3% respectively). Controlling for maternal age, diabetes mellitus, preterm delivery, birth weight, smoking, cesarean section, and fertility treatments, long IPI was found to be independently associated with high hazard for long-term pediatric neoplasm related hospitalizations (adjusted HR 1.39, 95% CI 1.09, 1.77). Short IPI may be associated to decreased hazard for childhood neoplasms (adjusted HR 0.74, 95% Cl 0.59, 0.92). Conclusions Long IPI is associated with a high hazard for childhood neoplasms, compared with intermediate and short IPIs. Short IPI may be associated with decreased hazard for childhood neoplasms.

Objectives The aim of this study is to determine the effect of interpregnancy interval (IPI) on the incidence of placenta previa and placenta accreta spectrum disorders in women with a previous cesarean section. Methods A prospective cohort three-center study involving parturients who had previous cesarean section was conducted. Participants were included if pregnancy has lasted up to 34 weeks. Parturients with co-existing uterine fibroids, multiple gestations, premature rupture of membranes, and those with prior postcesarean delivery wound infection were excluded. The eligible women recruited were distributed into two groups, namely, short (<18 months) and normal (18–36 months) IPI. The outcome measures were incidences of placenta previa and placenta accreta spectrum disorder and factors associated with the occurrence of placenta previa. A univariate analysis was performed using the chi-square test or Mann–Whitney U test, wherever appropriate, to examine the significance of the differences in clinical variables. Results A total of 248 women met the inclusion criteria. The incidence of placenta previa by ultrasound was 8.9% and 4.0% for short and normal IPI (odds ratios = 2.32; 95% confidence intervals = 0.78–6.88; p = 0.13), respectively. The incidence of placenta accreta spectrum disorder was 1.6% and 0.8% for short and normal IPI (odds ratios = 2.02; 95% confidence intervals = 0.18–22.13; p = 0.57), respectively. The only observed significant difference between the clinical variables and placenta previa is the number of cesarean sections (p = 0.02) in women with short IPI. Conclusion A short interpregnancy interval does not significantly affect the incidence of placenta previa and placenta accreta spectrum disorder following a cesarean section. There is a need for further study with large numbers to corroborate these findings in low- and middle-income settings.

Objective: To determine the effect of short inter-pregnancy interval on the outcome of vaginal birth after cesarean section.&#x0D; Study Design: Comparative cross-sectional study.&#x0D; Place and Duration of Study: Obstetrics and Gynecology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Oct 2021.&#x0D; Methodology: A total of 400 pregnant females were selected for this study. For every consecutive pregnant woman with a previous cesarean section and short inter-pregnancy interval (&lt;18 months) recruited into the study, a suitable control with inter-pregnancy interval ≥18 months were recruited.&#x0D; Results: Only 107(53.5 %) females with short interpregnancy interval had a successful vaginal birth after cesarean section, whereas 143(71.5 %) females with &gt;18 months’ inter-pregnancy interval had a successful VBAC. In patients with a history of vaginal delivery, the success of vaginal birth after the cesarean section was significantly higher than in those without previous vaginal delivery or VBAC (p=0.005). 231 out of 250(92.4%) pregnant females with spontaneous onset of labour had a successful VBAC compared to those who had induction of labour, 19(7.6%) (p=0.005). Patients who needed augmentation during delivery had a higher rate of undergoing a cesarean section than VBAC (p=0.003). However, no significant difference was observed in the spontaneous onset of labour and the need for induction and augmentation of labour for the inter-pregnancy interval.&#x0D; Conclusion: Our study concluded that with increasing inter-pregnancy interval, the chances of a successful VBAC increase (p=0.001) with fewer reported complications.

Background: Ensuring adequate interpregnancy interval enhances optimal maternal and fetal wellbeing while short interpregnancy interval which is interpregnancy interval less than 24 months is associated with adverse maternal and fetal outcomes.Objectives: To compare pregnancy outcome between short and normal interpregnancy interval at the University of Port Harcourt Teaching Hospital (UPTH).Methods: This was a prospective cross-sectional study involving 410 parturients (268 with short interpregnancy interval and 142 with normal interpregnancy interval) who consented and delivered at the UPTH. A structured proforma was used to obtain relevant information from the parturients. The data was analyzed using SPSS version 21.0. Pregnancy outcomes which include maternal anaemia, caesarean section rate, uterine rupture, abruption placenta, fetal distress, perinatal mortality between normal interpregnancy interval (NIPI) and short interpregnancy interval (SIPI) were compared using Chi square test and P value less than 0.05 was regarded as significant.Results: The mean age and parity of the study population were 32.59+0.38 and 2.69+0.44 respectively. One hundred and forty-two parturients had NIPI while 268 (65.4%) had SIPI. Parturients with SIPI were 1.4 times more likely to have caesarean delivery (OR=1.36, 95% CI= 0.88-2.11). Maternal anaemia (P = 0.026), abruptio placentae (P = 0.03) and ruptured uterus (P = 0.005) were significantly associated with SIPI. Low birth weight (P=0.1) and fetal demise (P=0.4) were not significantly associated with SIPI.Conclusion: Short interpregnancy interval was associated with significant adverse pregnancy outcome in this study. Ensuring adequate interpregnancy interval will improve outcomes.Keywords: Normal interpregnancy interval, Short interpregnancy interval,maternal outcome, fetal outcome.

Uterine activity was studied during labor in 36 women who had previous cesarean sections. There was no difference in uterine activity between those delivered vaginally (66%) or those who n...

Objective: To determine the frequency of uterine scar dehiscence during repeat cesarean section with short inter pregnancy interval (IPI). Methodology: This descriptive (cross-sectional) study was performed at the Department of Gynecology &amp; Obstetrics, Rawal Institute of Health Sciences (RIHS), Islamabad from December 2023 to June 2024. Patients presenting with singleton pregnancy, gestational age &gt;37 weeks, normal amount of liquor, normal placenta, having one or more previous cesarean sections, vertex presentation and inter pregnancy interval &lt;18 months were included. The scar dehiscence was observed during C-Section in Operation Theater. The data was analyzed using SPSS software version 23.0. Results: Mean age of total 150 women was 29 ± 2.30 years. Out of all 95(63.3%) patients were multi gravida and 55(36.7%) were grand multi gravida. 93(62%) patients had IPI ≤1 year, while and 57(38%) patients had IPI &gt;1 year. Overall the scar dehiscence was observed among 17 patients (11.3%). Additionally, there was no significant association was found with demographic and obstetric factors (p=&gt;0.05). Conclusion: The uterine scar dehiscence was observed to be highly frequent (11%), indicating that it remains a notable intraoperative finding in subsequent cesarean section among women with short IP.

Introduction: Interpregnancy interval has a major impact on the maternal and fetal health worldwide. Women with short interpregnancy interval show higher rates of low birth weight and preterm babies. So this study aimed to study the effect of interpregnancy interval on pregnancy outcomes.Methods: This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology of a tertiary care center after taking ethical approval from Institutional Review Committee (Reference number:229/080/081(6-11)E2). Data from September 1st, 2023 to January 30th, 2024 was collected. All multigravida women with singleton pregnancy after 28 weeks of gestation who delivered in our hospital with previous birth were enrolled in the study. Convenience sampling method was done. Point estimate and 95% Confidence Interval were calculated. The data was entered and analyzed using IBM SPSS Statistics version 26.0Results: Among the women , 31 (3.57%) women had short interpregnancy interval ≤18 months whereas 836 (96.43%) had interpregnancy interval of &gt;18 months. The mean age of the women was 28 years. Previous cesarean section was common indication of cesarean section 27 (87.09%) among women with short interpregnancy interval. These women had higher rates of preterm and low birth weight babies 11(35.58%) &amp; 15(48.38%).Conclusions: Women with short interpregnancy interval ≤18 months had higher preterm births and low birth weight babies. Pregnancy induced hypertension, hypothyroidism and gestational diabetes were increased in women with interpregnancy interval of &gt;18 months.

BackgroundFew studies have investigated the predictors of short and long interpregnancy intervals in Japan. Thus, this study investigated the maternal sociodemographic characteristics of short and long interpregnancy intervals among multiparous women using nationwide data in Japan.MethodsThe data of the Longitudinal Survey of Newborns in the 21st Century (2010 Cohort) in Japan were used, and the interpregnancy intervals of mothers were calculated. The age group, marital status, number of births, employment status, educational attainment of mothers, and household income were used as explanatory variables. Interpregnancy intervals of less than 12 months and 60 months or more were defined as short and long interpregnancy intervals, respectively. A modified Poisson regression model was employed to investigate the relationships between short and long interpregnancy intervals and maternal characteristics, and unadjusted and adjusted analyses were conducted.ResultsA total of 19,879 infants were used in the analysis. The results of the adjusted regression analysis showed that the risk ratio for short interpregnancy intervals increased with a decrease in maternal age, whereas the opposite trend was observed for long interpregnancy intervals. In addition, low educational attainment was positively associated with long interpregnancy intervals, and low household income was positively associated with short interpregnancy intervals. Employment status also played a role, with working mothers showing a negative association with short interpregnancy intervals and a positive association with long interpregnancy intervals.ConclusionsThis study showed that maternal sociodemographic characteristics such as employment status, educational attainment, and household income were associated with short and long interpregnancy intervals in Japan.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-24328-1.

Both short and long interpregnancy intervals (IPIs) have been associated with adverse birth outcomes. We undertook a multistate study to describe the prevalence of selected birth defects by IPI. We obtained data from nine population-based state birth defects registries for singleton live births in 2000-2009 among mothers with a previous live birth identified through birth certificates. IPI was calculated as the difference between prior birthdate and start of the current pregnancy (conception date). We estimated prevalence of selected defects per 10,000 live births and prevalence ratios (PRs) with 95% confidence intervals (CIs) overall and stratified by maternal age at previous birth and race/ethnicity. Primary analyses focused on short IPI < 6 months and long IPI ≥ 60 months compared to 18-23 months (referent). Sensitivity analyses limited to active-surveillance states and those with<10% missing IPI. Among 5,147,962 eligible births, 6.3% had short IPI while 19.8% had long IPI. Compared to referent, prevalence with short IPI was elevated for gastroschisis (3.7, CI: 3.0-4.5 vs. 2.0, CI: 1.6-2.4) and with both short and long IPI for tetralogy of Fallot (short: 3.4, 2.8-4.2 long: 3.8, 3.4-4.3 vs. 2.7, 2.3-3.2) and cleft lip ± palate (short: 9.9, 8.8-11.2 long: 9.2, 8.5-9.8 vs. 8.4, 7.6-9.2). Stratified analyses identified additional associations, including elevated prevalence of anencephaly with short IPI in younger mothers and limb defects with long IPI in those ages 25-34 at prior birth. Sensitivity analyses showed similar results. In this population-based study, we observed increased prevalence of several birth defects with short and long IPI.

Preliminary report of treatment with oral contraceptive pills for intermenstrual vaginal bleeding secondary to a cesarean section scar

Caesarean sections constitute major surgery, and are associated with immediate maternal and perinatal risks with implications on future pregnancies. After a caesarean delivery, the World Health Organization (WHO) recommends an Inter-pregnancy Interval (IPI) of at least 24 months to lower the risk of adverse maternal and perinatal outcomes in the subsequent pregnancy. However, whether the recommendation confers obstetric benefits is unclear as there’s paucity of data in low- and medium-income countries (LMIC). The objective was to determine the association between IPI length and maternal and neonatal outcomes in women with one previous caesarian section undergoing a repeat caesarian delivery at term in Pumwani Maternity Hospital between 1st January 2014 and 31st December 2018. A cross-sectional study was done where patients who had delivered via repeat caesarean section at term between 1st January 2014 and 31st December 2018 were evaluated. The files of 625 patients were retrieved and IPI was determined from the time interval between a previous caesarean section delivery and the beginning of the subsequent pregnancy, established from the date of the last normal menstrual period as recorded or extrapolated from an early trimester obstetric scan. The files were allotted to study groups as follows: = 170), 24 - 29 months/intermediate IPI (n = 384), and 60+ months/long IPI (n = 121) and data on sociodemographic/reproductive characteristics and maternal and neonatal outcomes abstracted and uploaded to SPSS (version 21) worksheet. Descriptive, bivariate, and multivariate logistic regression analyses were done and a p-value of 0.05 was considered statistically significant. The demographic and reproductive characteristics were comparable across the three IPI groups. Maternal outcomes such as uterine rupture, post-partum haemorrhage (PPH), blood transfusions, preeclampsia, and maternal mortality were comparable across short, intermediate, and long IPI. Some neonatal outcomes, however, showed evidence of an association with IPI. These were prematurity (p = 0.03) and developing congenital malformations (p = 0.01). Other neonatal outcomes (birth outcomes, birth weight, Apgar at 5, and NBU admission) were similar. In conclusion, maternal outcomes are comparable when the IPI after a repeat caesarean section at term is short, intermediate, and long. Congenital anomalies and premature births should be anticipated when the IPI is long (more than 59 months).

Background: Short inter-pregnancy interval has been associated with an increase risk of adverse pregnancy outcomes after caesarean section. Method: A descriptive study, carried out in tertiary care hospital on total 63 numbers of women for a duration of six months with short inter-pregnancy interval and history of previous caesarean section. Results: Among women with history of previous LSCS (n=63), mean age 26.5±4.6 years, gestational age 37.8±2.2 weeks, recommended IPI (&gt;18 months) was observed only in 15.9% women. Most common indications for current C-section were irregular pain (20.6%), term women (12.7%), and fetal distress (11.1%). Occurrence rate of uterine scar dehiscence was 33.3%, preterm birth 19.0%, low birth weight 15.9%, and uterine rupture 3.2%. Frequency of uterine scar dehiscence was significantly higher in IPI ≤6 months than in &gt;6 months (66.7% vs. 33.3%; p 0.040); and in IPI ≤12 months than in &gt;12 months (81% vs. 19%; p 0.036). All two cases of uterine rupture were observed in IPI ≤6 months but the difference was not statistically significant. Frequency of preterm birth was insignificantly higher in IPI ≤18 months than in &gt;18 months (66.7% vs. 33.3%; p 0.086). Conclusion: We found elevated risk of uterine scar dehiscence, uterine rupture, low birth weight babies along with preterm births. Keywords: IPI (Inter-pregnancy interval), LSCS (Lower Segment Cesarean Section), Scar dehiscence, Low Birth Weight.

Association Between Interpregnancy Interval and Adverse Neonatal and Maternal Outcomes Stratified by Gestational Age in Previous Pregnancy in China

Interpregnancy interval in multiparas: does it impact the labor curve?

There is a limited number of studies examining the influence of birth complications on the length of the subsequent interpregnancy interval (IPI). This study aimed to study the association between different pregnancy complications at first pregnancy and subsequent IPI. All women with their first and second pregnancies were gathered from the National Medical Birth Register for years 2004–2018. A logistic regression model was used to assess the association between the pregnancy complication (gestational hypertension, gestational diabetes (GDM), preterm birth, perinatal mortality, shoulder dystocia) in the first pregnancy and subsequent length of the IPI. IPIs with a length in the lower quartal were considered short IPIs, and length in the upper quartal as long IPIs. Adjusted odds ratios (aOR) with 95% CIs were compared between the groups. A total of 52,709 women with short IPI, 105,604 women with normal IPI, and 52,889 women with long IPI were included. Women with gestational hypertension had higher odds for long IPI (aOR 1.12, CI 1.06–1.19), GDM had higher odds for short IPI (aOR 1.09, CI 1.09–1.13), preterm delivery had higher odds for short and long IPI (aOR 1.12, CI 1.07–1.17 for both), and perinatal mortality had higher odds for short IPI (aOR 8.05, CI 6.97–9.32) and lower odds for long IPI (aOR 1.13, CI 0.93–1.38). Women with gestational hypertension and preterm birth had higher odds for long IPI, and women with diagnosed GDM and perinatal mortality had higher odds for short IPI. We found no evidence of a difference in the length of the IPI for women with shoulder dystocia. More research on the reasons behind the subsequent long and short IPI is warranted.