{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:01:37Z","timestamp":1760144497105,"version":"build-2065373602"},"reference-count":20,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T00:00:00Z","timestamp":1714089600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This study aims to report the location of the placenta in the first trimester of pregnancy in groups of women according to the number of previous caesarean deliveries and the visibility of the caesarean scar niche. Materials and\u00a0Methods: The prospective observational research included adult women aged 18 to 41 years during pregnancy after one or more previous caesarean sections (CSs). Transvaginal (TVS) and transabdominal sonography (TAS) was used to examine the uterine scar and placental location during 11\u201314 weeks. The CS scar niche (\u201cdefect\u201d) was bordered in the sagittal plane as a notch at the previous CS scar\u2019s site with a depth of 2.0 mm or more. A comparative analysis of the placental location (high or low and anterior or posterior) was performed between groups of women according to the CS number and the CS scar niche. Results: A total of 122 participants were enrolled during the first-trimester screening. The CS scar defect (\u201cniche\u201d) was visible in 40.2% of cases. In cases after one previous CS, the placenta was low in the uterine cavity (anterior or posterior) at 77.4%, and after two or more CSs, it was at 67.9%. Comparing the two groups according to the CS scar niche, the placenta was low in 75.5% of cases in the participant group with a CS scar niche and in 75% of cases without a CS scar niche (p = 0.949). Conclusions: The number of previous caesarean deliveries has no effect on the incidence rate of low-lying placentas in the first trimester. Moreover, the presence of the CS scar niche is not associated with anterior low-lying placentas.<\/jats:p>","DOI":"10.3390\/medicina60050719","type":"journal-article","created":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T10:56:32Z","timestamp":1714128992000},"page":"719","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Caesarean Section Scar and Placental Location at the First Trimester of Pregnancy\u2014A Prospective Longitudinal Study"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5384-0738","authenticated-orcid":false,"given":"Egle","family":"Savukyne","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Medicine Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mindaugas","family":"Kliucinskas","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Medicine Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Malakauskiene","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Medicine Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Berskiene","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Lithuanian University of Health Sciences, Tilzes Street\u2019 18, 47181 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3000605211054706","DOI":"10.1177\/03000605211054706","article-title":"Evaluation of the risk factors for antepartum hemorrhage in cases of placenta previa: A retrospective cohort study","volume":"49","author":"Kuribayashi","year":"2021","journal-title":"J. Int. Med. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1097\/AOG.0000000000004175","article-title":"Rethinking Prenatal Screening for Anomalies of Placental and Umbilical Cord Implantation","volume":"136","author":"Jauniaux","year":"2020","journal-title":"Obstet. Gynecol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1093\/humupd\/dmaa017","article-title":"Investigation of human trophoblast invasion in vitro","volume":"26","author":"Abbas","year":"2020","journal-title":"Hum. Reprod. Updat."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1002\/jum.15295","article-title":"Prospective First-Trimester Ultrasound Imaging of Low Implantation and Placenta Accreta Spectrum","volume":"39","author":"Happe","year":"2020","journal-title":"J. Ultrasound Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1111\/aogs.13834","article-title":"Development of placental abnormalities in location and anatomy","volume":"99","author":"Jansen","year":"2020","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1093\/humrep\/det110","article-title":"Does the presence of a Caesarean section scar affect implantation site and early pregnancy outcome in women attending an early pregnancy assessment unit?","volume":"28","author":"Naji","year":"2013","journal-title":"Hum. Reprod."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"102363","DOI":"10.1016\/j.bpobgyn.2023.102363","article-title":"Aetiology, risk factors and preventive strategies for niche development: A review","volume":"90","author":"Verberkt","year":"2023","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1002\/uog.22053","article-title":"Position and integrity of uterine scar are determined by degree of cervical dilatation at time of Cesarean section","volume":"57","author":"Kamel","year":"2021","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1136\/jclinpath-2021-207926","article-title":"Macrophage polarisation in caesarean scar diverticulum","volume":"76","author":"Huang","year":"2022","journal-title":"J. Clin. Pathol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Massimiani, M., Lacconi, V., La Civita, F., Ticconi, C., Rago, R., and Campagnolo, L. (2019). Molecular Signaling Regulating Endometrium\u2013Blastocyst Crosstalk. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21010023"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.ogc.2019.07.010","article-title":"Cesarean Scar Pregnancy","volume":"46","author":"Monteagudo","year":"2019","journal-title":"Obstet. Gynecol. Clin. N. Am."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1002\/uog.11133","article-title":"Does the presence of a Cesarean section scar influence the site of placental implantation and subsequent migration in future pregnancies: A prospective case\u2013control study","volume":"40","author":"Naji","year":"2012","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Ke, X., Liang, X.-F., Lin, Y.-H., and Wang, F. (2023). Pregnancy prediction via ultrasound-detected endometrial blood for hormone replacement therapy-frozen embryo transfer: A prospective observational study. Reprod. Biol. Endocrinol., 21.","DOI":"10.1186\/s12958-023-01164-9"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1093\/humrep\/dev343","article-title":"Assessment of the embryo flash position and migration with 3D ultrasound within 60 min of embryo transfer","volume":"31","author":"Saravelos","year":"2016","journal-title":"Hum. Reprod."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"ISUOG (2023). Practice Guidelines (updated): Performance of 11\u201314-week ultrasound scan. Ultrasound Obstet. Gynecol., 61, 127\u2013143.","DOI":"10.1002\/uog.26106"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.tjog.2017.04.012","article-title":"Placenta associated pregnancy complications in pregnancies complicated with placenta previa","volume":"56","author":"Baumfeld","year":"2017","journal-title":"Taiwan. J. Obstet. Gynecol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Savukyne, E., Machtejeviene, E., Paskauskas, S., Ramoniene, G., and Nadisauskiene, R.J. (2021). Transvaginal Sonographic Evaluation of Cesarean Section Scar Niche in Pregnancy: A Prospective Longitudinal Study. Medicina, 57.","DOI":"10.3390\/medicina57101091"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1089\/jwh.2020.8860","article-title":"Clinical Outcomes in High-Risk Pregnancies Due to Advanced Maternal Age","volume":"30","author":"Yoon","year":"2021","journal-title":"J. Women\u2019s Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.bpobgyn.2019.04.006","article-title":"New evidence-based diagnostic and management strategies for placenta accreta spectrum disorders","volume":"61","author":"Jauniaux","year":"2019","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Hooker, A.B., de Leeuw, R.A., Emanuel, M.H., Mijatovic, V., Brolmann, H.A.M., and Huirne, J.A. (2022). The link between intrauterine adhesions and impaired reproductive performance: A systematic review of the literature. BMC Pregnancy Childbirth, 22.","DOI":"10.1186\/s12884-022-05164-2"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/5\/719\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:34:13Z","timestamp":1760106853000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/5\/719"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,26]]},"references-count":20,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["medicina60050719"],"URL":"https:\/\/doi.org\/10.3390\/medicina60050719","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2024,4,26]]}}}