Does the appearance of the cutaneous scar after cesarean section reflect the residual myometrial thickness?
Open Access
- 7 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Archiv für Gynäkologie
- Vol. 303 (3), 847-851
- https://doi.org/10.1007/s00404-020-05943-2
Abstract
Purpose The aim of this study is to utilize the Manchester scar scale (MSS) and ultrasound in investigating the association between uterine wall defects and cutaneous scar characteristics after cesarean section (CS). Methods This is a prospective cohort study. The degree of myometrial loss was quantified by calculating a residual myometrial thickness (RMT) ratio as a percentage of RMT to the pre-cesarean anterior uterine wall thickness. Cutaneous scar assessment was performed according to the MSS. Spearman’s correlation and the Kruskal–Wallis test with a cut-off value of p < 0.05 were used for statistical analysis. Results Two hundred forty seven women, of which 2.4% had an Asian, 3.6% an Afro-American, 82% a Caucasian and 12% a Mediterranean background, were recruited. The RMT ratio ranged between 11.9 and 100% with a median of 55.8% and an average of 56%. MSS scores ranged from 4 to 13 with a median of 5 and an average of 6. Spearman’s correlation between MSS and RMT ratio show a rho of − 0.01 with a p value of 0.8. The correlation between MSS and RMT ratio within the four ethnical groups showed a p value between 0.3 and 0.8 and a rho between 0.8 and − 0.8. The Kruskal–Wallis test showed an eta2 of 0.13 and a p value of 0.0002 for the effect of ethnicity on MSS and an eta2 of 0.009 and a p value of 0.68 for the effect of ethnicity on the RMT ratio. Conclusion CS laparotomy scars heal differently between ethnical groups, but generally with satisfying results. Ethnicity does not affect myometrial healing and scar appearance does not reflect myometrial healing after CS. Thus, separate uterine sonographic assessment is recommended.Keywords
Funding Information
- Projekt DEAL
This publication has 25 references indexed in Scilit:
- Follicular and Scarring Disorders in Skin of Color: Presentation and ManagementAmerican Journal of Clinical Dermatology, 2014
- Patient Satisfaction and Cosmetic Outcome in a Randomized Study of Cesarean Skin ClosureObstetrics & Gynecology, 2014
- Cutaneous wound healing: recruiting developmental pathways for regenerationCellular and Molecular Life Sciences, 2012
- Current Strategies and Future Perspectives for Intraperitoneal Adhesion PreventionJournal of Gastrointestinal Surgery, 2012
- A reliable way to predict intraabdominal adhesions at repeat cesarean delivery: scar characteristicsActa Obstetricia et Gynecologica Scandinavica, 2011
- Cosmetic outcomes of various skin closure methods following cesarean delivery: a randomized trialAmerican Journal of Obstetrics and Gynecology, 2010
- High prevalence of defects in Cesarean section scars at transvaginal ultrasound examinationUltrasound in Obstetrics & Gynecology, 2009
- The hidden cost of skin scars: quality of life after skin scarringJournal of Plastic, Reconstructive & Aesthetic Surgery, 2008
- Cytokine and Growth Factor mRNA Expression Patterns Associated with the Hypercontracted, Hyperpigmented Healing Phenotype of Red Duroc Pigs: A Model of Abnormal Human Scar Development?Journal of Cutaneous Medicine and Surgery, 2005
- Skin scarringBMJ, 2003