Systematic review of cesarean scar assessment in the nonpregnant state: imaging techniques and uterine scar defect.


  • Date de publication : 2012-05-17

Référence

Roberge S, Boutin A, Chaillet N, Moore L, Jastrow N, Demers S, Bujold E. Systematic review of cesarean scar assessment in the nonpregnant state: imaging techniques and uterine scar defect. Am J Perinatol. 2012;29:465-71. doi: 10.1055/s-0032-1304829. PubMed PMID: 22399223.

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Mot(s) Clé(s)

adult cesarean section cicatrix female humans pregnancy radiography risk factors surgical wound dehiscence ultrasonography uterine rupture wound healing

Résumé

To review the ability of imaging techniques to predict incomplete healing of uterine cesarean scars before the next pregnancy.A systematic literature review searched for studies on women who underwent previous low-transverse cesarean, evaluated by hysterography, sonohysterography (SHG), or transvaginal ultrasound (TVU). The median prevalence of scar defects was computed with 95% confidence intervals (95% CIs). Odds ratio (OR, 95% CI) identified risk factors of incomplete healing.The analysis included 21 studies. The proportions of suspected scar defects detected by hysterography, SGH, and TVU were 58% (33 to 70), 59% (58 to 85), and 37% (20 to 65), respectively. Two studies found that women with a large uterine scar defect had a higher risk of uterine rupture or uterine scar dehiscence than those with no scar defect or small scar defect (OR: 26.05 [2.36 to 287.61], p <0.001). The only reported risk factor for scar defect was the occurrence of more than one previous cesarean (OR: 2.24 [1.13, 4.45], p = 0.02).Hysterography, SGH, and TVU can detect uterine scar defects in ~50% of women with previous cesarean.