| dc.description.abstract | Background: Cesarean scar defect niche is a complication of a cesarean section
that has long-term implications for both obstetrics and gynecology. The rate of
niche is believed increasing with the high number of cesarean sections. This
study's objective is to assess the risk factors for niche development after cesarean
section
Methods: A prospective cohort study was conducted on women who underwent
cesarean section at the Haji Adam Malik General Hospital between August 2021
and August 2022. Niche was assessed 6 weeks after cesarean section using
transvaginal ultrasonography. The main outcome was the presence of niche. The
antepartum, intrapartum dan postpartum risk factors were analyzed to niche
development. A logistic regression model was used to assess independent risk
factors from bivariate analysis
Results: There were 70 patients enrolled in this study. The prevalence of niche
was 44.3% by using transvaginal ultrasound. There was no significant relationship
between maternal age, gestational age, parity, nutritional status based on UAC,
hypertension in pregnancy, anemia status, surgical indications, locking or nonlocking
uterine closure, duration of surgery and volume blood loss and puerperal
infection to niche development (P > 0.05). The independent risk factors for niche
development were Cervical dilatation > 4 cm (P = 0.035; RR: 1.75), locking
suture technique (P = 0.015; RR = 13.81), non-closure vesicouterine folds (P =
0.04; RR = 0.14) and a retroflexed uterus (P = 0.001; RR: 0.039).
Conclusion: Cervical dilatation > 4 cm, locking suture technique, non-closure
vesicouterine folds, and a retroflexed uterus are risk factors for cesaeran scar
defect / niche development after CS | en_US |
