van der Voet Lucy F, Jordans Inge P M, Brölmann Hans A M, Veersema Sebastiaan, Huirne Judith A F
Department Gynaecology and Obstetrics, Deventer Hospital, Deventer, The Netherlands.
Gynecol Obstet Invest. 2018;83(2):164-170. doi: 10.1159/000478046. Epub 2017 Sep 29.
To study changes in a ceasarean section (CS) scar during the first year after a CS using gel installation sonography (GIS).
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.
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).
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.
使用凝胶置入超声检查（GIS）研究剖宫产术后第一年剖宫产瘢痕的变化。
概念验证研究，前瞻性队列研究。20例首次行剖宫产分娩的女性在剖宫产后2个月和1年接受经阴道超声检查和GIS评估。憩室定义为子宫剖宫产瘢痕处无回声区，深度>2mm。主要结局是通过GIS评估的残余肌层（RMT）厚度的任何变化。
剖宫产术后，平均RMT随时间变化，从术后2个月的11.9mm降至12个月时的6.5mm（p<0.001）。憩室患病率未改变。相邻肌层（AM）从15mm降至12.4mm（p=0.04）。GIS测量的RMT与AM的比值从2个月时的0.80降至12个月时的0.54（p=0.002）。
剖宫产术后2至12个月，RMT厚度、相邻肌层以及RMT与AM的比值降低。患病率未改变。在决定憩室测量时间和RMT解读时需要考虑这一点。
