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Does a Caesarean Section Scar Affect Placental Volume, Vascularity and Localization?
Diana Bokučava1,2, Anda Ķīvīte-Urtāne3,4, Pavels Domaševs2
1Department of Obstetrics and Gynecology, Rīga Stradiņš University, LV-1007 Rīga, Latvia.
Diagnostics (Basel, Switzerland)
|November 11, 2022
Summary
Previous C-sections did not significantly alter placental development in subsequent pregnancies. Advanced 3D ultrasound techniques did not detect differences in placental volume or vascularity in scarred uteri during the first trimester.
Area of Science:
- Reproductive Medicine
- Obstetrics and Gynecology
- Medical Imaging
Background:
- Caesarean section delivery increases risks for abnormal placental implantation and adverse pregnancy outcomes in subsequent pregnancies.
- Limited research exists on placental development alterations beyond placenta accreta spectrum in uteri with prior Caesarean scars.
Purpose of the Study:
- To assess placental development deviations in uteri with Caesarean section scars.
- To evaluate placental volume (PV) and vascular flow indexes using 3D power Doppler and VOCAL techniques.
Main Methods:
- Prospective study of 221 patients during first-trimester screening (Jan 2021 - Mar 2022).
- Measurement of placental volumes (PV) and vascularization indexes (VI, FI, VFI) using 3D power Doppler and VOCAL.
- Calculation of placental quotient (PQ) to standardize PV by gestational age.
Main Results:
- No significant differences in PV, PQ, or vascularization indexes between women with prior Caesarean section and vaginal delivery.
- Flow Index (FI) was significantly lower in nulliparous women during the first trimester.
- 3D placental evaluation did not detect placental development alterations in scarred uteri.
Conclusions:
- Current 3D ultrasound methods may not be sensitive enough to detect early placental development changes in uteri with Caesarean scars.
- Further research is needed to explore the utility of 3D power Doppler and VOCAL at earlier gestational ages.
