Observational studyBMC pregnancy and childbirth2022
Bacterial colonization at caesarean section defects in women of secondary infertility: an observational study.
Observational study in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Investigating the clinical manifestations associated with isthmocele: a meta-analysis study.Archives of gynecology and obstetrics · 2025Pooled it
- Prediction of preterm birth using 3D volume cesarean scar morphology in pregnant women with previous advanced labor cesarean delivery.Acta obstetricia et gynecologica Scandinavica · 2026Observational
- Frozen embryo transfer outcomes in patients with prior cesarean delivery: a focus on endometrial lining parameters.F&S reports · 2026Article
- High Risk of Chronic Endometritis in Isthmocele-A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Diagnostic yield of transvaginal ultrasonography versus saline: infused sonohysterography in the evaluation of post-cesarean section uterine niche.Journal of ultrasound · 2025Article
- Exosomes derived from hUC-MSCs exhibit ameliorative efficacy upon previous cesarean scar defect via orchestrating β-TrCP/CHK1 axis.Scientific reports · 2025Article
- Impact of caesarean scar defects on the success of assisted human reproduction: the NICHE-ART prospective French cohort study protocol.BMJ open · 2024Article
- Transvaginal uterine niche repair: surgical technique and outcome.Facts, views & vision in ObGyn · 2024Article
- Isthmocele and Infertility.Journal of clinical medicine · 2024Review
- Prevalence, definition, and etiology of cesarean scar defect and treatment of cesarean scar disorder: A narrative review.Reproductive medicine and biologyReview
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelayed childbearing has been noted in a high percentage of women with a previous Caesarean section (CS). Many women with CS scar defects (CSDs) present with clinical symptoms of irregular vaginal bleeding. The present study aimed to investigate bacterial colonies at CSDs in women suffering from secondary infertility.
methodsThis observational study included 363 women with secondary infertility who visited the Assisted Reproduction Unit between 2008 and 2013. Among them, 172 women with a previous CS and 191 women with no previous CS were approached. The women with a previous CS had their CS operations in the past 1 to 14 years, with a mean of 3.5 years. The presence of CSDs was detected by vaginal ultrasonography. Bacteriology cultures of specimens taken from the uterine niches in those with CSDs were collected during Day 7 to Day 10 of the follicular phase. Specimens were obtained from the endocervical canal for bacterial culture in those without CSDs. The main outcome measure was the detection of the growth of bacterial colonies.
resultsCSDs were found in 60.4% (96 of 159) of women with a previous CS. In women with a previous CS, bacterial colonies were identified in 89.6% (86 of 96) and 69.8% (44 of 63) of women with and without CSDs, respectively. In women with no previous CS, 49.7% (88 out of 177) of bacterial cultures of endocervical samples showed bacterial colony growth. Gram-positive cocci (P = 0.0017, odds ratio (OR) = 1.576, 95% confidence intervals (CI) -22.5 to - 5.4) and Gram-negative rods (P = 0.0016, OR = 1.74, CI - 20.8 to - 5.0) were the most commonly isolated bacteria and contributed to approximately 90% of all microorganisms found in those with a previous CS. In women with a previous CS, more Gram-negative rods were isolated (P = 0.01, OR = 1.765, CI - 27.2 to - 3.8), especially Pseudomonas species (P = 0.02, OR = 1.97, CI - 16.7 to - 1.0), in those with visible CSDs than in those without CSDs.
conclusionsBacterial colonization at CSDs was found in a high percentage of women with secondary infertility.
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