Investigating the risk factors for isthmocele development after cesarean delivery

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dc.contributor.authorFakhr, Masoud Saadat
dc.contributor.authorMozafari, Mahya
dc.contributor.authorRezvanfar, Kiana
dc.contributor.authorAmini, Zahra
dc.contributor.authorAmiri, Koosha
dc.contributor.authorHosseini, Reza Shah
dc.contributor.authorSarnaz, Hengame
dc.contributor.authorGholami, Poorya
dc.contributor.authorLavasani, Zohreh
dc.date.accessioned2024-05-29T09:15:24Z
dc.date.available2024-05-29T09:15:24Z
dc.date.issued2024
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi
dc.description.abstractBACKGROUND: Cesarean delivery rates are increasing globally, raising concerns about associated complications such as isthmocele. Isthmoceles are pouch-like defects in the anterior uterine wall at the site of a prior cesarean delivery scar. OBJECTIVE: This study aimed to determine isthmocele prevalence, associated symptoms, and risk factors among women with a history of cesarean delivery. STUDY DESIGN: This cross-sectional study evaluated 297 women with prior cesarean delivery using transvaginal ultrasound to screen for isthmocele. Data on demographics, pregnancy details, comorbidities, and indications for cesarean delivery were collected. Isthmocele was defined sonographically as any niche or defect at the hysterotomy site. Descriptive and comparative analyses identified factors associated with isthmocele. RESULTS: Isthmocele prevalence was 65.3% (n=194). Abnormal vaginal bleeding was reported in 21.1% of participants, pelvic pain by 4.1% of participants, and both by 4.1% of participants. Compared to women without isthmocele, those with isthmocele were older (35.9 vs 31.6 years), had higher body mass index (26.8 vs 25.5 kg/m2), gravidity (1.8 vs 1.3), and parity (1.7 vs 1.2). Repeat cesarean delivery was more common (30.4% vs 12.6%) and elective cesarean delivery less common (33.5% vs 67.9%) among those with isthmocele. CONCLUSION: Over half of the women with history of cesarean delivery had an isthmocele. Abnormal bleeding was common. Advanced maternal age, obesity, repeat procedures, and certain comorbidities appear to increase risk. Further research on prevention and treatment is warranted given the high prevalence.
dc.identifier.citationFakhr, M. S., Mozafari, M., Rezvanfar, K., Amini, Z., Amiri, K., Hosseini, R. S. ... Lavasani, Z. (2024). Investigating the risk factors for isthmocele development after cesarean delivery. AJOG Global Reports, 4(2). http://dx.doi.org/10.1016/j.xagr.2023.100299
dc.identifier.doi10.1016/j.xagr.2023.100299
dc.identifier.issn2666-5778
dc.identifier.issue2
dc.identifier.pmid38725541
dc.identifier.scopus2-s2.0-85191885596
dc.identifier.scopusqualityQ2
dc.identifier.urihttp://dx.doi.org/10.1016/j.xagr.2023.100299
dc.identifier.urihttps://hdl.handle.net/20.500.12511/12529
dc.identifier.volume4
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorHosseini, Reza Shah
dc.language.isoen
dc.relation.ispartofAJOG Global Reportsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution-NonCommercial-NoDerivs 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectAbnormal Uterine Bleeding
dc.subjectCesarean Delivery
dc.subjectCesarean Scar Defect
dc.subjectIsthmocele
dc.subjectUterine Niche
dc.titleInvestigating the risk factors for isthmocele development after cesarean delivery
dc.typeArticle

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