Evaluation of Association Between Adenomyosis and Cesarean Scar Defect

Fatemeh Shakki Katouli, Jayran Zebardast, Zahra Tavoli, Leila Bayani, Fahimeh Azizinik, Moein Moradpour, Reza Mardani, Najme Meimani, Somayeh Fathi
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2023 · vol. 43(3) , pp. 553–560 · doi:10.1002/jum.16388 · PMID:38088498 · W4389685513
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Symptomatic patients with adenomyosis demonstrated significantly larger cesarean scar defects and lower RMT/AMT ratios compared to those without adenomyosis.

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Abstract

PURPOSE: This study aims to investigate and compare quantitative factors of the cesarean scar defect (CSD) in symptomatic patients with and without uterine adenomyosis. METHOD: This study was conducted as a case-control study. Patients who met the inclusion criteria were divided into two groups: with adenomyosis (case) and without adenomyosis (control). The demographic data, medical history, and sonohysterography findings were extracted from the patient's documents and archived images. RESULT: During 2 years, 310 symptomatic women with a history of previous cesarean section underwent sonohysterography. Among them, 204 patients met the inclusion criteria. The most common chief complaints were post-menstrual bleeding (34.3%) and prolonged bleeding (27%). Cesarean scar depth and width significantly differed between these two groups, and patients with underlying adenomyosis had significantly larger defects (P-value of .009 and .005, respectively). Mean RMT/AMT ratio was 31.83% in the case group and 42.88% in the control group. In our study, RMT/AMT ratios were significantly lower in the case group (P-value of .001). In addition, we performed analysis on a subgroup of patients with one prior cesarean section. Similar results were achieved with a lower RMT/AMT ratio in case group (mean of 31.20% in case group and 46.47% in control group; P-value of .000). CONCLUSION: Our study showed a strong association between the presence of adenomyosis and larger clinically more significant CSDs. To establish a causative relationship, we suggest a prospective cohort study to follow up the patients and compare the evolution of CSD in patients with and without adenomyosis.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Cicatrix Cicatrix Cicatrix Cicatrix Cicatrix Cicatrix Cicatrix Cicatrix Case-Control Studies Case-Control Studies Case-Control Studies

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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