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Evaluation of Association Between Adenomyosis and Cesarean Scar Defect Publisher Pubmed



Shakki Katouli F1, 2 ; Zebardast J1, 3 ; Tavoli Z4 ; Bayani L1, 2 ; Azizinik F1, 5 ; Moradpour M6 ; Mardani R1, 2 ; Meimani N7 ; Fathi S1
Authors
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Authors Affiliations
  1. 1. Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Science, Tehran, Iran
  2. 2. Department of Radiology, Arash Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Cognitive Linguistics, Institute for Cognitive Science Studies (ICSS), Tehran, Iran
  4. 4. Department of Obstetrics and Gynecology, Ziaeeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Radiology, Yas and Amir-Alam Hospitals, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Radiology, Taleghani Hospital, Shahid Beheshti Medical University, Tehran, Iran
  7. 7. Research Center of Biomedical Technology and Robotics (RCBTR), Advanced Medical and Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Ultrasound in Medicine Published:2024


Abstract

Purpose: This study aims to investigate and compare quantitative factors of the cesarean scar defect (CSD) in symptomatic patients with and without uterine adenomyosis. Method: This study was conducted as a case–control study. Patients who met the inclusion criteria were divided into two groups: with adenomyosis (case) and without adenomyosis (control). The demographic data, medical history, and sonohysterography findings were extracted from the patient's documents and archived images. Result: During 2 years, 310 symptomatic women with a history of previous cesarean section underwent sonohysterography. Among them, 204 patients met the inclusion criteria. The most common chief complaints were post-menstrual bleeding (34.3%) and prolonged bleeding (27%). Cesarean scar depth and width significantly differed between these two groups, and patients with underlying adenomyosis had significantly larger defects (P-value of.009 and.005, respectively). Mean RMT/AMT ratio was 31.83% in the case group and 42.88% in the control group. In our study, RMT/AMT ratios were significantly lower in the case group (P-value of.001). In addition, we performed analysis on a subgroup of patients with one prior cesarean section. Similar results were achieved with a lower RMT/AMT ratio in case group (mean of 31.20% in case group and 46.47% in control group; P-value of.000). Conclusion: Our study showed a strong association between the presence of adenomyosis and larger clinically more significant CSDs. To establish a causative relationship, we suggest a prospective cohort study to follow up the patients and compare the evolution of CSD in patients with and without adenomyosis. © 2023 American Institute of Ultrasound in Medicine.
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