Citation Information :
Inessa S. Ultrasound Examination of the Uterine Scar after Cesarean Section: Isthmocele, Scar Pregnancy, Niche of Myometrium, and Low Uterine Segment Thickness. Donald School J Ultrasound Obstet Gynecol 2020; 14 (2):85-91.
The article is concerned with a review of contemporary concepts of the possibilities of ultrasound (US) evaluation of the uterine scar after the cesarean section (USCS) and provides clinical examples illustrated with US images. The possibilities of ultrasonographic evaluation of USCS abnormalities in nonpregnant patients as well as in the early stages of pregnancy are considered. The images of rare USCS abnormalities such as symptomatic isthmocele, scar pregnancy, and uterovesical fistula are presented. The possibilities of US for diagnostics of scar abnormalities in later pregnancy terms for prediction of successful vaginal delivery have been analyzed.
Birth After Previous Caesarean Birth; Royal College of Obstetricians and Gynaecologists (Green-top Guideline No.45) (2015).
Vikhareva O, Jokubkiene L, Valentin L. High prevalence of defects in cesarean section scars. Ultrasound Obstet Gynecol 2009;34(1):90–97. DOI: 10.1002/uog.6395.
Vikhareva O, Rickle GS, Lavesson T, et al. Hysterotomy level at cesarean section and occurrence of large scar defects: a randomized single-blind trial. Ultrasound Obstet Gynecol 2019;53(4):438–442. DOI: 10.1002/uog.20184.
Bij de Vaate AJ, van der Voet LF, Naji O, et al. Prevalence, potential risk factors for development and symptoms related to the presence of uterine niches following cesarean section: systematic review. Ultrasound Obstet Gynecol 2014;43(4):372–382. DOI: 10.1002/uog.13199.
Timor-Tritsch IE, Khatib N, Monteagudo A, et al. Cesarean scar pregnancies. J Ultrasound Med 2015;34:601–610. DOI: 10.7863/ultra.34.4.601.
Lesovoy V, Parashchuk Y, Shchukin D, et al. Case report: fetus in the bladder. rare complication of vesicouterine fistula. Case Rep Med 2016;2016:5750710. DOI: 10.1155/2016/5750710.
Paquette K, Markey S, Roberge S, et al. First and third trimester uterine scar thickness in women with previous caesarean: a prospective comparative study. J Obstet Gynaecol Can 2019;41(1):59–63. DOI: 10.1016/j.jogc.2018.02.020.
Jastrow N, Vikhareva O, Gauthier RJ, et al. Can third-trimester assessment of uterine scar in women with prior Cesarean section predict uterine rupture? Ultrasound Obstet Gynecol 2016;47(4): 410–414. DOI: 10.1002/uog.15786.
Bouet PE, Herondelle C. Uterine rupture with protruded legs in a large amniocele. N Engl J Med 2016;375:e51. DOI: 10.1056/NEJMicm1603843.
Hatstat LM. Sonographic assessment of uterine dehiscence during pregnancy in women with a history of cesarean section: a case series. J Diagn Med Sonogr 2016;32(5):283–286. DOI: 10.1177/8756479316661246.
Dy J, DeMeester S, Lipworth H, et al. No. 382-trial of labour after caesarean. J Obstet Gynaecol Can 2019;41(7):992–1011. DOI: 10.1016/j.jogc.2018.11.008.
Guise JM, Eden K, Emeis C, et al. Vaginal birth after cesarean: new insights. Evid Rep Technol Assess (Full Rep) 2010(191):1–397.
Basic E, Basic-Cetkovic V, Kozaric H, et al. Ultrasound evaluation of uterine scar after cesarean section and next birth. Med Arh. 2012;66(1):41–44. DOI: 10.5455/medarh.2012.66.s41-s44.
Kok N, Wiersma IC, Opmeer BC, et al. Sonographic measurement of lower uterine segment thickness to predict uterine rupture during a trial of labor in women with previous cesarean section: a meta-analysis. Ultrasound Obstet Gynecol 2014;42(2):132–139. DOI: 10.1002/uog.12479.
Sharma C, Surya M, Soni A, et al. Sonographic prediction of scar dehiscence in women with previous cesarean section. J Obstet Gynaecol India 2015;65(2):97–103. DOI: 10.1007/s13224-014-0630-4.
Uharček P, Breštanský A, Ravinger J, et al. Sonographic assessment of lower uterine segment thickness at term in women with previous cesarean delivery. Arch Gynecol Obstet 2015;292(3):609–612. DOI: 10.1007/s00404-015-3687-0.
