Postpartum Changes in Uterine Position and Occurrence of Cesarean Scar Defects: A Retrospective Observational Study
Background: Over the past several decades, rates of cesarean delivery have increased considerably worldwide. As cesarean section (CS) may also result in changes to uterine position, the relationship between delivery modes, postpartum uterine position and cesarean scar defect (CSD) warrants elucidati...
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IMR Press
2022-07-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/49/7/10.31083/j.ceog4907159 |
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| author | Hongjie Pan Ailing Gu Yu Yang Zhouhui Chen Fengbing Liang |
| author_facet | Hongjie Pan Ailing Gu Yu Yang Zhouhui Chen Fengbing Liang |
| author_sort | Hongjie Pan |
| collection | DOAJ |
| description | Background: Over the past several decades, rates of cesarean delivery have increased considerably worldwide. As cesarean section (CS) may also result in changes to uterine position, the relationship between delivery modes, postpartum uterine position and cesarean scar defect (CSD) warrants elucidation. Materials & Methods: Here, we conducted a retrospective observational study evaluating 921 women (482 underwent vaginal delivery and 439 underwent CS) who had undergone transvaginal ultrasonography (TVU) early in their pregnancy (<8 weeks). Subsequent ultrasonography was performed 3–6 months postpartum to evaluate uterine position for all women and saline infusion sonohysterography (SIS) for women who underwent CS. The outcome was the uterine position for all of the women and the CSD for women underwent CS. Results: A total of 716 women (371 of whom underwent vaginal delivery and 345 of whom underwent CS) were concluded in the study. Postpartum uterine position was found to be significantly changed from anteflexion (81.9% for vaginal delivery and 82.0% for CS) to retroflexion (29.1% for vaginal delivery and 46.7% for CS) after both vaginal (p < 0.001) and CS (p < 0.001) deliveries. CSD was diagnosed by SIS in 146 of 345 (42.3 95% CI 37.1–47.6) women that underwent CS. CSD prevalence among anteflexed and retroflexed uterus were 46.7% (95% CI 39.5%–54.0%) and 37.3% (95% CI 29.7%–44.8%), respectively (p = 0.08). Conclusions: This study revealed that uterus became retroflexed in patients who underwent either CS or vaginal deliveries. CS resulted in a significantly greater proportion of retroflexed uterus than did vaginal delivery. CSD prevalence among women with retroflexed uterus in the postpartum has no difference with those with anteflexed uterus. |
| format | Article |
| id | doaj-art-fbdc2d5c84b04e5da6caced15df0e0ca |
| institution | DOAJ |
| issn | 0390-6663 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-fbdc2d5c84b04e5da6caced15df0e0ca2025-08-20T03:06:19ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-07-0149715910.31083/j.ceog4907159S0390-6663(22)01793-6Postpartum Changes in Uterine Position and Occurrence of Cesarean Scar Defects: A Retrospective Observational StudyHongjie Pan0Ailing Gu1Yu Yang2Zhouhui Chen3Fengbing Liang4Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 310016 Hangzhou, Zhejiang, ChinaDepartment of Obstetrics and Gynecology, Wuxi Second Hospital of Traditional Chinese Medicine, 214121 Wuxi, Jiangsu, ChinaDepartment of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, 200240 Shanghai, ChinaDepartment of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 310016 Hangzhou, Zhejiang, ChinaDepartment of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 310016 Hangzhou, Zhejiang, ChinaBackground: Over the past several decades, rates of cesarean delivery have increased considerably worldwide. As cesarean section (CS) may also result in changes to uterine position, the relationship between delivery modes, postpartum uterine position and cesarean scar defect (CSD) warrants elucidation. Materials & Methods: Here, we conducted a retrospective observational study evaluating 921 women (482 underwent vaginal delivery and 439 underwent CS) who had undergone transvaginal ultrasonography (TVU) early in their pregnancy (<8 weeks). Subsequent ultrasonography was performed 3–6 months postpartum to evaluate uterine position for all women and saline infusion sonohysterography (SIS) for women who underwent CS. The outcome was the uterine position for all of the women and the CSD for women underwent CS. Results: A total of 716 women (371 of whom underwent vaginal delivery and 345 of whom underwent CS) were concluded in the study. Postpartum uterine position was found to be significantly changed from anteflexion (81.9% for vaginal delivery and 82.0% for CS) to retroflexion (29.1% for vaginal delivery and 46.7% for CS) after both vaginal (p < 0.001) and CS (p < 0.001) deliveries. CSD was diagnosed by SIS in 146 of 345 (42.3 95% CI 37.1–47.6) women that underwent CS. CSD prevalence among anteflexed and retroflexed uterus were 46.7% (95% CI 39.5%–54.0%) and 37.3% (95% CI 29.7%–44.8%), respectively (p = 0.08). Conclusions: This study revealed that uterus became retroflexed in patients who underwent either CS or vaginal deliveries. CS resulted in a significantly greater proportion of retroflexed uterus than did vaginal delivery. CSD prevalence among women with retroflexed uterus in the postpartum has no difference with those with anteflexed uterus.https://www.imrpress.com/journal/CEOG/49/7/10.31083/j.ceog4907159cesarean scar defectcesarean sectionmechanical analysisuterine flexionvaginal delivery |
| spellingShingle | Hongjie Pan Ailing Gu Yu Yang Zhouhui Chen Fengbing Liang Postpartum Changes in Uterine Position and Occurrence of Cesarean Scar Defects: A Retrospective Observational Study Clinical and Experimental Obstetrics & Gynecology cesarean scar defect cesarean section mechanical analysis uterine flexion vaginal delivery |
| title | Postpartum Changes in Uterine Position and Occurrence of Cesarean Scar Defects: A Retrospective Observational Study |
| title_full | Postpartum Changes in Uterine Position and Occurrence of Cesarean Scar Defects: A Retrospective Observational Study |
| title_fullStr | Postpartum Changes in Uterine Position and Occurrence of Cesarean Scar Defects: A Retrospective Observational Study |
| title_full_unstemmed | Postpartum Changes in Uterine Position and Occurrence of Cesarean Scar Defects: A Retrospective Observational Study |
| title_short | Postpartum Changes in Uterine Position and Occurrence of Cesarean Scar Defects: A Retrospective Observational Study |
| title_sort | postpartum changes in uterine position and occurrence of cesarean scar defects a retrospective observational study |
| topic | cesarean scar defect cesarean section mechanical analysis uterine flexion vaginal delivery |
| url | https://www.imrpress.com/journal/CEOG/49/7/10.31083/j.ceog4907159 |
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