@article{046071833e564d95a71557b182ee299e,
title = "Changes in the Uterine Scar during the First Year after a Caesarean Section: A Prospective Longitudinal Study",
abstract = "Aim: To study changes in a ceasarean section (CS) scar during the first year after a CS using gel installation sonography (GIS). Methods: Proof-of-concept study, prospective cohort study. Twenty women who delivered by their first CS were evaluated by both transvaginal sonography and GIS 2 months and 1 year after CS. A niche was defined as an anechogenic space at the uterine caesarean scar with a depth >2 mm. The primary outcome was any change in the thickness of the residual myometrium (RMT) as evaluated by GIS. Results: Mean RMT changed in time from 11.9 mm at 2 months to 6.5 mm at 12 months after the CS (p < 0.001). Niche prevalence did not change. The adjacent myometrium (AM) reduced from 15 to 12.4 mm (p = 0.04). The ratio between RMT and AM with GIS decreased from 0.80 at 2 months to 0.54 at 12 months (p = 0.002). Conclusion: RMT thickness, the adjacent myometium and the ratio between the RMT and AM reduces from 2 to 12 months after a CS. The prevalence did not change. This needs to be taken into account when deciding on the timing of niche measurement and the interpretation of the RMT.",
keywords = "Caesarean section scar, Niche, Sonohysterography, Ultrasound",
author = "Voet, {Lucy Lucet F van der} and Jordans, {Inge P.M.} and Br{\"o}lmann, {Hans A M} and Sebastiaan Veersema and Huirne, {Judith A F}",
note = "Funding Information: We thank K.W. Van den Berg-Swart and C. van Dam-Bourens, research nurses, for recording the collected data in the database. J.A.F.H. received 2 grants from ZonMw, a Dutch organization for Health Research and development for to compare (1) the effect of a hysteroscopic niche resection versus no treatment in women with postmenstrual spotting (Hysniche study, ZonMw project number 80-82305-97-12030) and (2) the (cost)effectiveness of double-layer closure of the caesarean (uterine) scar in the prevention of gynaecological symptoms in relation to niche development (ZonMw project number 843002605) and received grants from Samsung Medison and Gedeon Richter outside the submitted work. H.A.M.B. received grants from Olympus and Gynesonics and non-financial support from Samsung Medison, outside this study. Funding Information: J.A.F.H. received 2 grants from ZonMw, a Dutch organization for Health Research and development for to compare (1) the effect of a hysteroscopic niche resection versus no treatment in women with postmenstrual spotting (Hysniche study, ZonMw project number 80-82305-97-12030) and (2) the (cost)effectiveness of double-layer closure of the caesarean (uterine) scar in the prevention of gynaecological symptoms in relation to niche development (ZonMw project number 843002605) and received grants from Samsung Medison and Gedeon Richter outside the submitted work. H.A.M.B. received grants from Olympus and Gynesonics and non-financial support from Samsung Medison, outside this study. S.V. is consultant for Bayer and Norvartis. He is a member of the advisory board of Hologic and Johnson and Johnson. And S.V. is patentee for a new hysteroscopy. Publisher Copyright: {\textcopyright} 2017 S. Karger AG, Basel.",
year = "2018",
month = mar,
day = "1",
doi = "10.1159/000478046",
language = "English",
volume = "83",
pages = "164--170",
journal = "Gynecologic and Obstetric Investigation",
issn = "0378-7346",
publisher = "S. Karger AG",
number = "2",
}