Department of Obstetrics and Gynaecology, Medicine Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
Department of Sports Medicine, Lithuanian University of Health Sciences, Tilzes Street' 18, 47181 Kaunas, Lithuania.
Medicina (Kaunas). 2024 Apr 26;60(5):719. doi: 10.3390/medicina60050719.
: This study aims to report the location of the placenta in the first trimester of pregnancy in groups of women according to the number of previous caesarean deliveries and the visibility of the caesarean scar niche. : The prospective observational research included adult women aged 18 to 41 years during pregnancy after one or more previous caesarean sections (CSs). Transvaginal (TVS) and transabdominal sonography (TAS) was used to examine the uterine scar and placental location during 11-14 weeks. The CS scar niche ("defect") was bordered in the sagittal plane as a notch at the previous CS scar's site with a depth of 2.0 mm or more. A comparative analysis of the placental location (high or low and anterior or posterior) was performed between groups of women according to the CS number and the CS scar niche. : A total of 122 participants were enrolled during the first-trimester screening. The CS scar defect ("niche") was visible in 40.2% of cases. In cases after one previous CS, the placenta was low in the uterine cavity (anterior or posterior) at 77.4%, and after two or more CSs, it was at 67.9%. Comparing the two groups according to the CS scar niche, the placenta was low in 75.5% of cases in the participant group with a CS scar niche and in 75% of cases without a CS scar niche ( = 0.949). : The number of previous caesarean deliveries has no effect on the incidence rate of low-lying placentas in the first trimester. Moreover, the presence of the CS scar niche is not associated with anterior low-lying placentas.
本研究旨在报告根据既往剖宫产次数和剖宫产瘢痕憩室（CS 瘢痕憩室）可见性分组的孕妇在妊娠早期胎盘的位置。前瞻性观察性研究纳入了既往有一次或多次剖宫产的 18 至 41 岁成年孕妇。在 11-14 周时，采用经阴道超声（TVS）和经腹超声（TAS）检查子宫瘢痕和胎盘位置。CS 瘢痕憩室（“缺陷”）在矢状面以先前 CS 瘢痕部位的切迹边界，深度≥2.0mm。根据 CS 数量和 CS 瘢痕憩室，对不同 CS 数量和 CS 瘢痕憩室组的胎盘位置（高低和前后）进行了比较分析。在早孕期筛查期间，共有 122 名参与者入组。40.2%的病例可见 CS 瘢痕缺陷（“憩室”）。在既往有一次剖宫产的病例中，胎盘在子宫腔内位置较低（前后）的比例为 77.4%，在有两次或更多剖宫产的病例中，胎盘位置较低的比例为 67.9%。根据 CS 瘢痕憩室将两组进行比较，在有 CS 瘢痕憩室的参与者组中，胎盘位置较低的比例为 75.5%，在没有 CS 瘢痕憩室的参与者组中，胎盘位置较低的比例为 75%（ = 0.949）。既往剖宫产次数对早孕期低置胎盘的发生率没有影响。此外，CS 瘢痕憩室的存在与前壁低置胎盘无关。
