Yan Chen1, Ping Han2, Yi-Jia Wang2, Yan-Xia Li2. 1. Department of Obstetrics and Gynecology, North China University of Science and Technology Affiliated Hospital, No. 73 Jianshe road, Tangshan, 063000, Hebei, China. yanchen0806@yahoo.com. 2. Department of Obstetrics and Gynecology, North China University of Science and Technology Affiliated Hospital, No. 73 Jianshe road, Tangshan, 063000, Hebei, China.
Abstract
OBJECTIVE: To analyze related risk factors of post-cesarean scar defects (PCSDs). METHODS: A retrospective study of full-term women delivered by cesarean with singleton infants at our hospital from April 2014 to December 2015 was performed. 69 cases of diagnosed PCSDs and 107 cases with no PCSD who accepted cesarean were recruited for analysis. Individual medical case and operative report review were retrieved for maternal clinical characteristics analysis. RESULTS: There was no difference in age, gestational age, BMI and baby's weight between the two groups. PCSD group has more cases of anemia, higher neutrophil percentage and more cases of elected cesarean and emergency cesarean than controls (all p < 0.05). For woman who received emergency cesarean, there were more cases with cervix dilated larger than 3 cm in operation and more cases received cesarean at least one time before. In addition, women with cesarean interval of at least 5 years, women with ultrasonic measured echo longer than 3 cm, women with poor healing in uterine incision, women with retroposition of uterus and women who had intrauterine separation are more prone to develop PCSDs. CONCLUSIONS: The occurrence of a defective uterine scar after cesarean section is primarily a by-product of the combination of multiple factors: age ≥30 years, BMI ≥27.30, premature rupture of membranes, elective cesarean section, post-operative anemia, WBC count ≥12.5 × 109 g/L and retroposition of uterus. These are high risk factors of PCSDs.
OBJECTIVE: To analyze related risk factors of post-cesarean scar defects (PCSDs). METHODS: A retrospective study of full-term women delivered by cesarean with singleton infants at our hospital from April 2014 to December 2015 was performed. 69 cases of diagnosed PCSDs and 107 cases with no PCSD who accepted cesarean were recruited for analysis. Individual medical case and operative report review were retrieved for maternal clinical characteristics analysis. RESULTS: There was no difference in age, gestational age, BMI and baby's weight between the two groups. PCSD group has more cases of anemia, higher neutrophil percentage and more cases of elected cesarean and emergency cesarean than controls (all p < 0.05). For woman who received emergency cesarean, there were more cases with cervix dilated larger than 3 cm in operation and more cases received cesarean at least one time before. In addition, women with cesarean interval of at least 5 years, women with ultrasonic measured echo longer than 3 cm, women with poor healing in uterine incision, women with retroposition of uterus and women who had intrauterine separation are more prone to develop PCSDs. CONCLUSIONS: The occurrence of a defective uterine scar after cesarean section is primarily a by-product of the combination of multiple factors: age ≥30 years, BMI ≥27.30, premature rupture of membranes, elective cesarean section, post-operative anemia, WBC count ≥12.5 × 109 g/L and retroposition of uterus. These are high risk factors of PCSDs.
Authors: Anna Sarah Erem; Thomas Okpoti Konney; Adu Appiah-Kubi; Kwasi Ankomah; Adu Tutu Amankwa; John Jude Kweku Annan; Augustine Tawiah; Benjamin Kwame Amoako-Adjei; Kwabena Fosu Lartey; Emma R Lawrence Journal: Am J Case Rep Date: 2020-12-28