Systematic Review of Cesarean Scar Assessment in the Nonpregnant State: Imaging Techniques and Uterine Scar Defect

被引:192
作者
Roberge, Stephanie [1 ,2 ,3 ]
Boutin, Amelie [1 ,2 ,3 ]
Chaillet, Nils [4 ]
Moore, Lynne [2 ,5 ]
Jastrow, Nicole [6 ]
Demers, Suzanne [1 ]
Bujold, Emmanuel [1 ,2 ,3 ]
机构
[1] Univ Laval, Dept Obstet & Gynecol, Fac Med, Quebec City, PQ G1V 4G2, Canada
[2] Univ Laval, Dept Social & Prevent Med, Fac Med, Quebec City, PQ G1V 4G2, Canada
[3] Ctr Hosp Univ Quebec CRCHUQ, Ctr Rech, Quebec City, PQ, Canada
[4] Univ Montreal, Fac Med, Dept Obstet & Gynecol, Montreal, PQ H3C 3J7, Canada
[5] Univ Quebec, Ctr Hosp Affilie, Hop Enfant Jesus, Quebec City, PQ, Canada
[6] Univ Geneva, HUG, Fac Med, Dept Obstet & Gynecol, Geneva, Switzerland
基金
加拿大健康研究院;
关键词
scar defects; cesarean; imaging techniques; ultrasound; DOUBLE-LAYER CLOSURE; SECTION SCAR; SINGLE-LAYER; RISK; HYSTEROGRAPHY; INCISION; RUPTURE; SEGMENT; DELIVERY; TRIAL;
D O I
10.1055/s-0032-1304829
中图分类号
R71 [妇产科学];
学科分类号
100211 [妇产科学];
摘要
Objective To review the ability of imaging techniques to predict incomplete healing of uterine cesarean scars before the next pregnancy. Study Design 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. Results 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). Conclusion Hysterography, SGH, and TVU can detect uterine scar defects in similar to 50% of women with previous cesarean.
引用
收藏
页码:465 / 471
页数:7
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