{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:47:07Z","timestamp":1787240827816,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T00:00:00Z","timestamp":1554163200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To study the association between the level of Cesarean hysterotomy and the presence of large uterine scar defects 6\u20139\u2009months after delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a two\u2010center, randomized, single\u2010blind trial of a surgical procedure with masked assessment of the principal outcome under study. Women without a history of Cesarean section (CS) who underwent emergency CS at cervical dilatation \u2265\u20095\u2009cm were randomized to high or low incision. Hysterotomy was performed 2\u2009cm above and 2\u2009cm below the plica vesicouterina in the high and low incision groups, respectively. Women were examined using saline contrast sonohysterography to assess the appearance of the hysterotomy scar 6\u20139\u2009months after delivery. The main outcome was presence of a large scar defect, defined as the remaining myometrial thickness over the defect being \u2264\u20092.5\u2009mm. Secondary outcomes were perinatal outcome, operative complications within 8\u2009weeks after delivery and long\u2010term outcome in a subsequent pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 122 patients enrolled in the trial, 114 were assessed by ultrasound examination, of whom 55 were randomized to high and 59 to low CS incision. Large scar defects were seen in four (7%) women in the high\u2010incision group and in 24 (41%) in the low\u2010incision group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001; odds ratio, 8.7 (95% CI, 2.8\u201327.4)). There were no differences in operative complications and perinatal outcomes between the two groups. The median follow\u2010up time was 4\u2009years and 7\u2009months, during which 56 (49%) women had a subsequent pregnancy. No significant differences were observed in the rate of complications in subsequent pregnancy and delivery between women who had low and those who had high incision at the index CS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low Cesarean hysterotomy level in women in advanced labor is associated with higher incidence of large scar defects detected by transvaginal ultrasound examination 6\u20139\u2009months after delivery. Copyright \u00a9 2018 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.20184","type":"journal-article","created":{"date-parts":[[2018,11,28]],"date-time":"2018-11-28T12:01:55Z","timestamp":1543406515000},"page":"438-442","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["Hysterotomy level at Cesarean section and occurrence of large scar defects: a randomized single\u2010blind trial"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5356-7009","authenticated-orcid":false,"given":"O.","family":"Vikhareva","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Sk\u00e5ne University Hospital Malm\u00f6 Lund University  Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. S.","family":"Rickle","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Sk\u00e5ne University Hospital Malm\u00f6 Lund University  Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Lavesson","sequence":"additional","affiliation":[{"name":"Campus Helsingborg, Clinical Science Faculty of Medicine Lund University  Helsingborg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Nedopekina","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Sk\u00e5ne University Hospital Malm\u00f6 Lund University  Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Brandell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Sk\u00e5ne University Hospital Malm\u00f6 Lund University  Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. \u00c5.","family":"Salvesen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, St. Olavs Hospital Trondheim University Hospital  Trondheim Norway"},{"name":"Department of Clinical and Molecular Medicine Norwegian University of Science and Technology  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4160-4224-2.50039-9"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.15553"},{"key":"e_1_2_6_4_1","unstructured":"Euro\u2010Peristat Project with SCPE and EUROCAT. 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