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Effects of diabetes mellitus and cervical changes on scar healing after cesarean section Cover

Effects of diabetes mellitus and cervical changes on scar healing after cesarean section

Journal of Ultrasonography
Volume 24 (2024): Issue 99 (December 2024)
By: Şükran Doğru,  Huriye Ezveci,  Fatih Akkuş,  Fikriye Karanfil Yaman,  Elifsena Canan Alp and  Kazim Gezginç  
Open Access
|Dec 2024

Figures & Tables

Fig. 1.

Cesarean section incision area healed with a niche. The red line indicates residual myometrial thickness (RMT), the blue line indicates proximal RMT, and the black line indicates distal RMT
Cesarean section incision area healed with a niche. The red line indicates residual myometrial thickness (RMT), the blue line indicates proximal RMT, and the black line indicates distal RMT

Fig. 2.

Cesarean scar incision area healed with fibrosis. The black line indicates residual myometrial thickness (RMT), the blue line indicates proximal RMT, and the green line indicates distal RMT
Cesarean scar incision area healed with fibrosis. The black line indicates residual myometrial thickness (RMT), the blue line indicates proximal RMT, and the green line indicates distal RMT

Fig. 3.

Residual myometrial thickness (RMT), proximal RMT, and distal RMT values of the entire study group based on cervical changes
Residual myometrial thickness (RMT), proximal RMT, and distal RMT values of the entire study group based on cervical changes

Evaluation of cesarean section area in the study group according to cervical changes

ParametersDM active labor (n = 29)DM latent labor (n = 56)Control active labor (n = 35)Control latent labor (n = 50)P
Age30.03 ± 4.8031.73 ± 4.7027.94 ± 5.0228.86 ± 6.250.005*
Gestational week37.47 ± 2.4537.36 ± 1.6538.27 ± 2.4637.33 ± 1.950.150*
Fetal weight3350.41 ±739.973285.57 ±638.562835.57 ±763.502954.20 ± 663.080.002*
BMI31.78 ± 2.4132.94 ± 5.5129.32 ± 5.1028.24 ± 4.540.0001*
Fetal positionVertex29 (100%)54 (96.4%)28 (80.0%)43 (86.0%)0.011Ψ
Breech0 (0%)a2 (3.6%)a7 (20.0%)b7 (14.0%)a
Niche positivity9 (31.0%)18 (32.1%)15 (42.9%)17 (34.0%)0.712Ψ
RMT4.35 ± 2.403.66 ± 1.955.13 ± 2.577.85 ± 4.450.0001*
Proximal RMT7.17 ± 2.437.05 ± 2.349.65 ± 3.4412.16 ± 4.310.0001*
Distal RMT6.90 ± 2.006.98 ± 2.028.09 ± 3.0410.06 ± 3.690.0001*

Evaluation of sociodemographic and cesarean scar characteristics of study groups

Diabetes group (n = 85)Control group (n = 85)P
Maternal age (year)31.15 ± 4.7728.48 ± 5.760.0001¥
Gestational age (week)37.40 ± 1.9437.72 ± 2.210.315Φ
BMI (kg/m2)32.5 ± 4.7028.68 ± 4.780.0001Φ
Fetal weight (gram)3307.69 ± 671.172905.24 ± 704.200.001¥
RMT3,90 ± 2,126,73 ± 4,000.0001Φ
Proximal RMT7,09 ± 2,3611,12 ± 4,140.0001Φ
Distal RMT6,95 ± 2,009,25 ± 3,550.0001¥
Niche positivity27(31.8%)32 (37.6%)0.420Ψ
Weight gain (kg)14.6 ± 8.4
Diabetic statusGDM64 (75.3%)
PDM21 (24.7%)
Treatment methodDiet43 (50.6%)
Insulin42 (49.4%)

Distribution of myometrial thicknesses according to niche presence

DM group (n = 85)PControl group (n = 85)P
Niche(+) (n = 27)Niche(−) (n = 58) Niche(+) (n = 32)Niche(−) (n = 53)
RMT3.69 ± 2.103.99 ± 2.140.5505.39 ± 3.747.53 ± 3.960.016Φ
Proximal RMT7.37 ± 2.776.95 ± 2.150.447¥10.73 ± 3.4311.36 ± 4.530.474Φ
Distal RMT7.23 ± 2.246.82 ± 1.880.381¥8.77 ± 2.099.53 ± 4.190.265¥

Evaluation of cesarean scar area according to diabetes type and treatment

PDM (n = 21)GDM (n = 64)P
RMT4.76 ± 2.823.61 ± 1.780.032Φ
Proximal RMT7.96 ± 3.096.80 ± 2.020.118¥
Distal RMT7.85 ± 2.686.66 ± 1.640.017Φ
Niche positivity5 (23.8%)22 (34.4%)0.367Ψ
Diet therapy group (n = 43)Insulin therapy group (n = 42)P
RMT3.47 ± 1.504.33 ± 2.550.198¥
Proximal RMT6.72 ± 1.717.45 ± 2.850.370¥
Distal RMT6.82 ± 1.627.08 ± 2.330.930¥
Niche positivity18 (41.9%)9 (21.4%)0.043Ψ

Multivariate linear regression analysis of the effects of demographic and clinical characteristics on RMT

BetaSEß95 % CIp-value
Age0.0190.0490.030–0.077 – 0.1160.693
BMI0.0010.0540.001–0.107 – 0.1070.997
Fetal weight0.0010.001–0.091–0.001 – 0.0010.222
Presence of diabetes–2.7040.557–0.388–3.803 – –1.6040.001
DOI: https://doi.org/10.15557/jou.2024.0035 | Journal eISSN: 2451-070X | Journal ISSN: 2084-8404
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Language: English
Page range: 1 - 7
Submitted on: Apr 14, 2024
Accepted on: Jul 30, 2024
Published on: Dec 23, 2024
Published by: MEDICAL COMMUNICATIONS Sp. z o.o.
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
diabetes mellitus,
niche,
cesarean scar,
residual myometrial thickness
Related subjects:
Medicine,
Basic medical science,
Basic medical science, other

© 2024 Şükran Doğru, Huriye Ezveci, Fatih Akkuş, Fikriye Karanfil Yaman, Elifsena Canan Alp, Kazim Gezginç, published by MEDICAL COMMUNICATIONS Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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