ArticleJournal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine2025
Three-Dimensional Volume Ultrasound Assessment of Cesarean Scar Niche and Cervix in Pregnant Women: A Reproducibility Study.
Article in Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Ultrasound-guided bladder localization for predicting abdominal adhesions, bladder injury, and scar healing in repeat cesarean sections: a prospective cohort study.International urology and nephrology · 2026Article
- 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
- Layered precision suturing vs. traditional double-layer closure at cesarean: a randomized trial of uterine scar healing and maternal outcomes.Frontiers in surgery · 2026Article
- Uterine cervical volume: comparison between two- and three-dimensional ultrasound methods at 20-24 weeks of gestation.Radiologia brasileiraArticle
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the reproducibility of standardized 3-dimensional (3D) ultrasound volume analysis of the dimensions and the position of cesarean birth (CB) scar niche relative to the cervix in pregnant women.
methodsThis prospective single-center study in women with 1 previous CB ≥8 cm cervical dilatation acquired ultrasound volumes between 11 and 24 weeks' gestation in a mid-sagittal plane. Two experienced operators processed the volumes using virtual organ computer-aided analysis. A CB scar niche was defined as an indentation at the scar site of ≥2 mm in depth. Niche and cervix volumes were calculated using manual contouring. Agreement for categorical variables was expressed using intraclass correlation coefficient (ICC). The Bland-Altman method was used to assess numerical variable reproducibility.
resultsTo achieve the desired statistical power, 52 participants were included. The intraobserver agreement on niche classification relative to the internal os was 100%, with an interobserver kappa coefficient of 0.98 (95% confidence interval [CI] 0.97-0.99, P < .05). The intraobserver ICC for niche volume was 0.94 (95% CI 0.90-0.96; P < .001), with a mean difference of -15.32 mm
conclusionsThis study demonstrates that 3D CB scar sonographic features are highly reproducible in pregnant women with a history of advanced labor CB. The validated protocol can guide future research on the association with subsequent adverse pregnancy outcomes.
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