{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T11:43:35Z","timestamp":1789386215902,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,4,6]],"date-time":"2016-04-06T00:00:00Z","timestamp":1459900800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether Cesarean scar defect (<jats:styled-content style=\"fixed-case\">CSD<\/jats:styled-content>) parameters assessed by transvaginal sonography (<jats:styled-content style=\"fixed-case\">TVS<\/jats:styled-content>) might affect the outcome of early termination of pregnancy (<jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content>) with mifepristone\u2013misoprostol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective review of 183 women with previous Cesarean delivery who received oral mifepristone and misoprostol for <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content>. A successful <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content> was defined by the absence of an intrauterine gestational sac, with no need for surgical intervention. <jats:styled-content style=\"fixed-case\">CSD<\/jats:styled-content> was diagnosed by <jats:styled-content style=\"fixed-case\">TVS<\/jats:styled-content> in the presence of a hypoechogenic indentation within the myometrium of the lower uterine segment at the site of a previous Cesarean incision. Women were analyzed in three subgroups according to size of defect (ratio of residual myometrial thickness over the defect to adjacent myometrial thickness &lt; 30%, 30%\u201370% and &gt; 70%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 183 women, 43 (23.5%) had failure of <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content>. Fifty\u2010nine (32.2%) had <jats:styled-content style=\"fixed-case\">CSD<\/jats:styled-content> detectable at <jats:styled-content style=\"fixed-case\">TVS<\/jats:styled-content>, and these women had a higher failure rate of <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content> than did those without <jats:styled-content style=\"fixed-case\">CSD<\/jats:styled-content> (38.9% <jats:italic>vs<\/jats:italic> 16.1%; <jats:italic>P<\/jats:italic> = 0.001). <jats:styled-content style=\"fixed-case\">CSD<\/jats:styled-content> was associated significantly with failure of <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content> (odds ratio, 3.32 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.64\u20136.75)). The <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content> failure rates in relation to defect size in the myometrial thickness ratio &lt; 30%, 30%\u201370% and &gt; 70% subgroups were 57.1%, 25.0% and 18.2%, respectively. There was a linear trend in failure rate across these ratios (Cochran\u2013Armitage trend test; <jats:italic>P<\/jats:italic> = 0.015).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women with <jats:styled-content style=\"fixed-case\">CSD<\/jats:styled-content> are at increased risk of failed <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content>. Women with a defect in which  the residual myometrial thickness was &lt; 30% of the adjacent myometrial thickness tended to have a greater chance of failed <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">CSD<\/jats:styled-content> detected at <jats:styled-content style=\"fixed-case\">TVS<\/jats:styled-content> is of clinical relevance in counseling women with a history of Cesarean delivery who are considering <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content>. Copyright \u00a9 2015 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.14877","type":"journal-article","created":{"date-parts":[[2015,4,11]],"date-time":"2015-04-11T08:05:51Z","timestamp":1428739551000},"page":"506-510","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Association between ultrasonographic parameters of Cesarean scar defect and outcome of early termination of pregnancy"],"prefix":"10.1002","volume":"47","author":[{"given":"H.\u2010K.","family":"Au","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, College of Medicine Taipei Medical University  Taipei Taiwan"},{"name":"Department of Obstetrics and Gynecology Taipei Medical University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.\u2010F.","family":"Liu","sequence":"additional","affiliation":[{"name":"Graduate Institute of Integration of Traditional Chinese Medicine with Western Nursing National Taipei University of Nursing and Health Sciences  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.\u2010R.","family":"Tzeng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, College of Medicine Taipei Medical University  Taipei Taiwan"},{"name":"Department of Obstetrics and Gynecology Taipei Medical University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.\u2010W.","family":"Chien","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, College of Medicine Taipei Medical University  Taipei Taiwan"},{"name":"Department of Obstetrics and Gynecology Taipei Medical University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,4,6]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2010.03.006"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2011.11.010"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.03.007"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2005.04.014"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/13625187.2012.671386"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e318263c699"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13199"},{"key":"e_1_2_5_9_1","first-page":"227","article-title":"Clinical observation on termination of early pregnancy of 213 cases after caesarean section with repeated use of mifepristone and misoprostol","volume":"10","author":"Gao P","year":"1999","journal-title":"Reprod Contracept"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(00)00341-6"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1341-8076.2003.00108.x"},{"issue":"626","key":"e_1_2_5_12_1","first-page":"e1","article-title":"Misoprostol for treatment of early pregnancy failure in women with previous uterine surgery","volume":"198","author":"Chen BA","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31819638e6"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2009.09.013"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gyobfe.2011.07.047"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1028-4559(09)60016-4"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5200"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6395"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6405"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318209abf0"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2013.03.008"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10077"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-014-0365-3"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2007.00786.x"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61870-5"}],"container-title":["Ultrasound in Obstetrics &amp; 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