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Analysis of risk factors for previous cesarean scar defect |
WANG Jingxuan, LU Dan, and WEI Wei |
Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China |
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Abstract Objective To analyze the risk factors for previous cesarean scar defect.Methods Totally 128 patients who had received cesarean section were recruited in the study. Fifty-six of the cases came to visit a doctor because of previous cesarean scar defect between January 2013 and December 2015, while the other seventy-two cases had their scars healed under the vaginal ultrasound and with no symptoms related to previous cesarean scar defect .The medical records included general conditions(age, uterine position, gestational age, gravidity and parity history and neonatal weight) and perioperative conditions (pregnancy complications, puerperal infection, time of operation, and ways of incision suture) were collected. Risk factors for previous cesarean scar defect were analyzed.Results There were more cases of retroflexed uterus, delivery, cesarean sections, patients with gestational diabetes mellitus, cesarean sections during the second stage of labor, and more cases of single layer closure incision (P<0.05) in the group with previous cesarean scar defect. The risk factors for previous cesarean scar defect were the retroflexed uterus(OR=0.370, P<0.05), multiple cesarean sections(OR=0.147, P<0.01), cesarean sections during the second stage of labor (OR=0.543, P<0.05), and incisions with single layer closure(OR=11.126, P<0.05).Conclusions Rigorous control of indications, proper timing of cesarean sections, and improving surgical expertise are effective means of reducing the risk of previous cesarean scar defect.
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Received: 10 June 2016
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