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A preliminary study of uterine scar tissue following cesarean section
Cailin Wu1,2, Xin Chen1, Zhixiong Mei3
1Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
Aim:
To compare smooth muscle cells, type I collagen, and apoptosis of the lower uterine segment of women who had/without a prior cesarean delivery.
Methods:
Alpha smooth muscle actin (α-SMA), type I collagen, and nuclear apoptosis were compared between the groups from lower uterine segment. Twenty-eight controls and 82 with one prior cesarean delivery were included. The women with a prior cesarean section were classified by time since the surgery: ≤3 years, >3 and ≤5 years, >5 and ≤7 years, >7 and ≤9 years, and >9 years.
Results:
Smooth muscle volume density (VD) % was significantly lower in women who had cesarean sections in first three groups than in the controls (all, P<0.01). Type I collagen VD% was similar among all groups and the controls. The number of apoptotic nuclei in the lower uterine segment of the scarred group was greater up to 3 years after surgery and less than in the control at 7-9 years. The number of non-apoptotic nuclei in the scarred group was greater than controls up to 7 years after surgery.
Conclusion:
The lower uterine segment scar becomes stable at 3 years after cesarean delivery, and by 9 years, the scar is mature.
