Transvaginal 3D Ultrasound Evaluation of Post-Cesarean Section Uterine Diverticulum
Open Journal of Obstetrics and Gynecology
Objectives: This study focused on evaluating the value of transvaginal 3D ultrasound for the diagnosis and prognostic assessment of post-cesarean section uterine diverticulum. Materials and Methods: We retrospectively analyzed the data from 32 patients with post-cesarean section uterine diverticulum over three recent years. In all patients, transvaginal 3D ultrasound was used to measure the size of the uterine diverticulum and the thickness of the lower uterine segment (LUS) and myometrium.
... and myometrium. Patients with a LUS with a myometrial thickness under 4 mm underwent resection and repair surgery; those with a LUS with a myometrial thickness over 4 mm underwent hysteroscopic resection. The postoperative sonograms were compared with preoperative images to evaluate the efficacy of various treatments. Results: The mean length, width and depth of the uterine diverticula were 18.30 ± 2.80 mm, 9.14 ± 3.20 mm and 11.49 ± 2.71 mm, respectively. The average LUS myometrial thickness was 3.40 ± 0.80 mm (with a range of 1.6 mm -6.3 mm). After surgery, two patients' sonograms still showed diverticula at the post-cesarean section scar, measuring 6 mm × 7 mm × 6 mm and 6 mm × 8 mm × 4 mm. There were significant differences in the size of uterine diverticula between preoperative and postoperative sonograms (P < 0.05) and the effective rate of surgery was 93.75% (30/32). Conclusions: Transvaginal 3D ultrasound is an accurate method for detecting post-cesarean section uterine diverticulum and is helpful for assessing surgical options and prognosis. The LUS myometrial thickness, which is considered as an optional index of post-cesarean section uterine diverticulum, should be measured routinely.