TY - JOUR
T1 - Routine revision of uterine scar after cesarean section
T2 - Has it ever been necessary?
AU - Silberstein, T.
AU - Wiznitzer, A.
AU - Katz, M.
AU - Friger, M.
AU - Mazor, M.
PY - 1998/5/1
Y1 - 1998/5/1
N2 - Although a trial of labor after cesarean section (VBAC) is successful and relatively safe, few studies have directly addressed the necessity of routine transcervical revision of uterine scar after prior cesarean section. We performed a longitudinal study of 3469 women who had VBAC. In all patients, uterine scar integrity was examined immediately after placental expulsion. The detection rate of uterine scar dehiscence or rupture was 0.23% (8/3469). Only one woman with complete uterine rupture needed immediate laparotomy for severe hemorrhage. Out of seven patients (0.2%), who had evidence of uterine dehiscence, three underwent explorative laparotomy. In conclusion, the potential benefit of routine examination of uterine scar after VBAC is doubtful. Transcervical revision should be performed only in symptomatic patients.
AB - Although a trial of labor after cesarean section (VBAC) is successful and relatively safe, few studies have directly addressed the necessity of routine transcervical revision of uterine scar after prior cesarean section. We performed a longitudinal study of 3469 women who had VBAC. In all patients, uterine scar integrity was examined immediately after placental expulsion. The detection rate of uterine scar dehiscence or rupture was 0.23% (8/3469). Only one woman with complete uterine rupture needed immediate laparotomy for severe hemorrhage. Out of seven patients (0.2%), who had evidence of uterine dehiscence, three underwent explorative laparotomy. In conclusion, the potential benefit of routine examination of uterine scar after VBAC is doubtful. Transcervical revision should be performed only in symptomatic patients.
KW - Dehiscence
KW - Rupture
KW - Transcervical revision
KW - Uterine scar
KW - VBAC
UR - http://www.scopus.com/inward/record.url?scp=0031955268&partnerID=8YFLogxK
U2 - 10.1016/S0301-2115(98)00005-0
DO - 10.1016/S0301-2115(98)00005-0
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C2 - 9605445
AN - SCOPUS:0031955268
SN - 0301-2115
VL - 78
SP - 29
EP - 32
JO - European Journal of Obstetrics and Gynecology and Reproductive Biology
JF - European Journal of Obstetrics and Gynecology and Reproductive Biology
IS - 1
ER -