Risk factors for the development of ceasarean scar defects: A longitudinal study
Main Article Content
Abstract
This prospective longitudinal study of 381 women undergoing primary ceasarean delivery investigated risk factors for uterine niche at 12 months postpartum. The incidence of niche was 35.9% and large niche with residual myometrial thickness < 3mm was 15.2%. Multivariate logistic regression revealed that advanced cervical dilatation (≥ 6cm) at the time of delivery was an independent predictor, increasing the risk of developing niche 6.8 times (95%CI: 3.91 - 11.9, p = 0.00). In addition, single-layer uterine closure was associated with a higher likelihood of large niche with RMT < 3mm compared to double-layer closure (95% CI: 1.1 - 3.3, p = 0.04). Other demographic and obstetric characteristics were not significantly associated. These findings highlight the critical role of labor progression and surgical technique in scar healing, emphasizing the importance of optimizing clinical decision-making and uterine closure methods to reduce long-term complications related to ceasarean scars.
Article Details
Keywords
Ceasarean section, scar defect, risk factors, cervical dilatation, uterine closure technique
References
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