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A transvaginal ultrasound-based diagnostic calculator for uterus post-cesarean scar defect
BACKGROUND: A cesarean scar defect (CSD) is incomplete healing of the myometrium at the site of a prior cesarean section (CS), complicating more than half of all cesarean sections. While transvaginal ultrasound (TVU) is the most common modality for diagnosing this defect, hysteroscopy remains the go...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10612219/ https://www.ncbi.nlm.nih.gov/pubmed/37891612 http://dx.doi.org/10.1186/s12905-023-02715-3 |
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author | Allameh, Zahra Rouholamin, Safoura Rasti, Sina Adibi, Atoosa Foroughi, Zahra Goharian, Maryam Rad, Mehrdad Rabiee Dabaghi, Ghazal Ghasempour |
author_facet | Allameh, Zahra Rouholamin, Safoura Rasti, Sina Adibi, Atoosa Foroughi, Zahra Goharian, Maryam Rad, Mehrdad Rabiee Dabaghi, Ghazal Ghasempour |
author_sort | Allameh, Zahra |
collection | PubMed |
description | BACKGROUND: A cesarean scar defect (CSD) is incomplete healing of the myometrium at the site of a prior cesarean section (CS), complicating more than half of all cesarean sections. While transvaginal ultrasound (TVU) is the most common modality for diagnosing this defect, hysteroscopy remains the gold standard. We aimed to develop an efficient diagnostic tool for CSD among women with abnormal uterine bleeding (AUB) by integrating TVU findings and participants’ demographic features. METHODS: A single-center cross-sectional study was conducted on 100 premenopausal and non-pregnant women with a history of CS complaining of AUB without a known systemic or structural etiology. Each participant underwent a hysteroscopy followed by a TVU the next day. The defect dimensions in TVU, patients’ age, and the number of previous CSs were integrated into a binary logistic regression model to evaluate their predictive ability for a hysteroscopy-confirmed CSD. RESULTS: Hysteroscopy identified 74 (74%) participants with CSD. The variables age, the number of CSs, defect length, and defect width significantly contributed to the logistic regression model to diagnose CSD with odds ratios of 9.7, 0.7, 2.6, and 1.7, respectively. The developed model exhibited accuracy, sensitivity, and specificity of 88.00%, 91.89%, and 76.92%, respectively. The area under the receiver operating curve was 0.955 (P-value < 0.001). CONCLUSION: Among non-pregnant women suspected of CSD due to AUB, looking at age, the number of previous CSs, and TVU-based defect width and length can efficiently rule CSD out. |
format | Online Article Text |
id | pubmed-10612219 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-106122192023-10-29 A transvaginal ultrasound-based diagnostic calculator for uterus post-cesarean scar defect Allameh, Zahra Rouholamin, Safoura Rasti, Sina Adibi, Atoosa Foroughi, Zahra Goharian, Maryam Rad, Mehrdad Rabiee Dabaghi, Ghazal Ghasempour BMC Womens Health Research BACKGROUND: A cesarean scar defect (CSD) is incomplete healing of the myometrium at the site of a prior cesarean section (CS), complicating more than half of all cesarean sections. While transvaginal ultrasound (TVU) is the most common modality for diagnosing this defect, hysteroscopy remains the gold standard. We aimed to develop an efficient diagnostic tool for CSD among women with abnormal uterine bleeding (AUB) by integrating TVU findings and participants’ demographic features. METHODS: A single-center cross-sectional study was conducted on 100 premenopausal and non-pregnant women with a history of CS complaining of AUB without a known systemic or structural etiology. Each participant underwent a hysteroscopy followed by a TVU the next day. The defect dimensions in TVU, patients’ age, and the number of previous CSs were integrated into a binary logistic regression model to evaluate their predictive ability for a hysteroscopy-confirmed CSD. RESULTS: Hysteroscopy identified 74 (74%) participants with CSD. The variables age, the number of CSs, defect length, and defect width significantly contributed to the logistic regression model to diagnose CSD with odds ratios of 9.7, 0.7, 2.6, and 1.7, respectively. The developed model exhibited accuracy, sensitivity, and specificity of 88.00%, 91.89%, and 76.92%, respectively. The area under the receiver operating curve was 0.955 (P-value < 0.001). CONCLUSION: Among non-pregnant women suspected of CSD due to AUB, looking at age, the number of previous CSs, and TVU-based defect width and length can efficiently rule CSD out. BioMed Central 2023-10-27 /pmc/articles/PMC10612219/ /pubmed/37891612 http://dx.doi.org/10.1186/s12905-023-02715-3 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Allameh, Zahra Rouholamin, Safoura Rasti, Sina Adibi, Atoosa Foroughi, Zahra Goharian, Maryam Rad, Mehrdad Rabiee Dabaghi, Ghazal Ghasempour A transvaginal ultrasound-based diagnostic calculator for uterus post-cesarean scar defect |
title | A transvaginal ultrasound-based diagnostic calculator for uterus post-cesarean scar defect |
title_full | A transvaginal ultrasound-based diagnostic calculator for uterus post-cesarean scar defect |
title_fullStr | A transvaginal ultrasound-based diagnostic calculator for uterus post-cesarean scar defect |
title_full_unstemmed | A transvaginal ultrasound-based diagnostic calculator for uterus post-cesarean scar defect |
title_short | A transvaginal ultrasound-based diagnostic calculator for uterus post-cesarean scar defect |
title_sort | transvaginal ultrasound-based diagnostic calculator for uterus post-cesarean scar defect |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10612219/ https://www.ncbi.nlm.nih.gov/pubmed/37891612 http://dx.doi.org/10.1186/s12905-023-02715-3 |
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