Evidence map›Paper›PMID 38725541›Full record

ArticleAJOG global reports2024

Investigating the risk factors for isthmocele development after cesarean delivery.

Masoud Saadat Fakhr, Mahya Mozafari, Kiana Rezvanfar, Zahra Amini, Koosha Amiri, Reza Shah Hosseini, Hengame Sarnaz, Poorya Gholami, Zohreh Lavasani

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In one paragraph

Article in AJOG global reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Masoud Saadat FakhrFaculty of Medicine, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran (Drs Fakhr, Mozafari, Rezvanfar, Amini, Amiri, Sarnaz, and Gholami).
Mahya MozafariFaculty of Medicine, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran (Drs Fakhr, Mozafari, Rezvanfar, Amini, Amiri, Sarnaz, and Gholami).
Kiana RezvanfarFaculty of Medicine, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran (Drs Fakhr, Mozafari, Rezvanfar, Amini, Amiri, Sarnaz, and Gholami).
Zahra AminiFaculty of Medicine, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran (Drs Fakhr, Mozafari, Rezvanfar, Amini, Amiri, Sarnaz, and Gholami).
Koosha AmiriFaculty of Medicine, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran (Drs Fakhr, Mozafari, Rezvanfar, Amini, Amiri, Sarnaz, and Gholami).
Reza Shah HosseiniFaculty of Medicine, Istanbul Medipol University, Istanbul, Turkey (Mr Hosseini).
Hengame SarnazFaculty of Medicine, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran (Drs Fakhr, Mozafari, Rezvanfar, Amini, Amiri, Sarnaz, and Gholami).
Poorya GholamiFaculty of Medicine, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran (Drs Fakhr, Mozafari, Rezvanfar, Amini, Amiri, Sarnaz, and Gholami).
Zohreh LavasaniDepartment of Obstetrics and Gynecology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran (Dr Lavasani).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCesarean delivery rates are increasing globally, raising concerns about associated complications such as isthmocele. Isthmoceles are pouch-like defects in the anterior uterine wall at the site of a prior cesarean delivery scar.

objectiveThis study aimed to determine isthmocele prevalence, associated symptoms, and risk factors among women with a history of cesarean delivery. STUDY

designThis cross-sectional study evaluated 297 women with prior cesarean delivery using transvaginal ultrasound to screen for isthmocele. Data on demographics, pregnancy details, comorbidities, and indications for cesarean delivery were collected. Isthmocele was defined sonographically as any niche or defect at the hysterotomy site. Descriptive and comparative analyses identified factors associated with isthmocele.

resultsIsthmocele prevalence was 65.3% (n=194). Abnormal vaginal bleeding was reported in 21.1% of participants, pelvic pain by 4.1% of participants, and both by 4.1% of participants. Compared to women without isthmocele, those with isthmocele were older (35.9 vs 31.6 years), had higher body mass index (26.8 vs 25.5 kg/m

conclusionOver half of the women with history of cesarean delivery had an isthmocele. Abnormal bleeding was common. Advanced maternal age, obesity, repeat procedures, and certain comorbidities appear to increase risk. Further research on prevention and treatment is warranted given the high prevalence.

Indexed as

abnormal uterine bleedingcesarean deliverycesarean scar defectisthmoceleuterine niche

Identifiers

PMID38725541
PMCPMC11078695

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.