Long-term complications of caesarean section. The niche in the scar: a prospective cohort study on niche prevalence and its relation to abnormal uterine bleeding
Long-term complications of caesarean section. The niche in the scar: a prospective cohort study on niche prevalence and its relation to abnormal uterine bleeding
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DOI：
10.1111/1471-0528.12542
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发表时间：
2014-01-01
影响因子：
5.8
通讯作者：
Huirne, J. A. F.
中科院分区：
文献类型：
--
作者：
van der Voet, L. F.;de Vaate, A. M. Bij;Huirne, J. A. F.
目的研究随机人群中剖腹产疤痕壁龛的患病率，以及与经后点滴和尿失禁的关系。设计一项前瞻性队列研究。设置在荷兰的一所教学医院。人口非孕妇剖腹产分娩。方法经阴道超声（TVU）和凝胶滴注超声宫腔造影（GIS）进行剖腹产后6- 12周。在剖腹产后6- 12周、6个月和12个月对妇女进行问卷调查和月经评分表。主要结果测量剖腹产后6- 12周的小生境患病率，使用TVU和GIS。次要结局：关系到产后点滴和尿失禁6个月和12个月后剖腹产;和生态位的特点，TVU和GIS. ResultsTwenty和63名妇女被纳入。生态位流行率在TVU和GIS的评估分别为49.6%和64.5%。女性与GIS测量的生态位比女性没有一个生态位（OR 5.48，95%CI 1.14-26.48），月经后斑点。子宫瘢痕部位残留子宫肌层的女性，其测量值为相邻子宫肌层厚度的50%（OR 6.13，95% CI 1.74-21.63）。尿失禁是不相关的存在niche.ConclusionsA龛是存在于64.5%的妇女剖腹产后6- 12周，当检查GIS。经后点状出血更常见于有小凹的妇女和子宫肌层残余厚度为
ObjectiveTo study the prevalence of niches in the caesarean scar in a random population, and the relationship with postmenstrual spotting and urinary incontinence.DesignA prospective cohort study.SettingA teaching hospital in the Netherlands.PopulationNon-pregnant women delivered by caesarean section.MethodsTransvaginal ultrasound (TVU) and gel instillation sonohysterography (GIS) were performed 6-12weeks after caesarean section. Women were followed by questionnaire and menstruation score chart at 6-12weeks, 6months, and 12months after caesarean section.Main outcome measuresPrevalence of a niche 6-12weeks after caesarean section, using TVU and GIS. Secondary outcomes: relation to postmenstrual spotting and urinary incontinence 6 and 12months after caesarean section; and niche characteristics, evaluated by TVU and GIS.ResultsTwo hundred and sixty-three women were included. Niche prevalence was 49.6% on evaluation with TVU and 64.5% with GIS. Women with a niche measured by GIS reported more postmenstrual spotting than women without a niche (OR 5.48, 95% CI 1.14-26.48). Women with residual myometrium at the site of the uterine scar measuring 50% of the adjacent myometrial thickness (OR 6.13, 95% CI 1.74-21.63). Urinary incontinence was not related to the presence of a niche.ConclusionsA niche is present in 64.5% of women 6-12weeks after caesarean section, when examined by GIS. Postmenstrual spotting is more prevalent in women with a niche and in women with a residual myometrial thickness of