Strain elastography of the uterus after spontaneous labor and cesarean section

The aim of the study was to assess the strain elastography value in myometrium changes according to the delivery method. The study included 159 women with full-term pregnancy, 30 of them after spontaneous labor (control group) and 129 after cesarean section (main group). The cesarean section was performed during the labor in 85 patients and before the onset of labor in 44 patients. The postpartum (postoperative) period was uncomplicated in all cases. The B-mode ultrasound was performed as a first step. At the second step, the elasticity of different parts of the uterus (anterior wall of the uterus, scar (isthmus), cervix) was evaluated with real-time tissue elastography. Elasticity indices (ratio of the region of interest elasticity to the reference area elasticity) were calculated. The reference area was in the posterior wall close to the uterine fundus. In all 159 cases examinations were performed on the 4^th day after delivery and additionally in 3 month after spontaneous labor in 26 women and after cesarean section in 34 women. The elasticity of the uterine tissue in the scar area was lower in compare to the other parts of the uterus in the early postoperative period and 3 months after delivery. The decrease of the elasticity was the most notable on the 4^th day after prelabor cesarean section. In 3 month the differences in elasticity indices values between groups of the prelabor and intrapartum cesarean section was not significant. Another feature was the combination of the low scar elasticity with the higher elasticity of the surrounding uterine tissue. Strain elastography allows to assess the myometrium elastic proprieties and to identify signs specific to the delivery method.

ультразвуковое исследование, ультразвуковая эластография, компрессионная эластография, рубец на матке, кесарево сечение, ultrasound, ultrasound elastography, strain elastography, uterine scar, caesarean section

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