Caesarean section during labor: risk factors for the formation of an incompetent uterine scar

Objective. To evaluate the impact of labor phase, obstetric and gynecological history, and somatic conditions on the formation of the postoperative uterine scar after cesarean section (CS). Materials and methods. A prospective study included 212 women with term singleton pregnancies who underwent CS at various stages of labor. Three months postpartum, all patients underwent transvaginal ultrasound to measure residual myometrial thickness (RMT) and calculate the scar healing ratio. Results. Performing CS during the active phase of labor and at full cervical dilation was associated with a reduction in RMT (3.3 mm vs. 3.5 mm in elective CS; p < 0.01). Adverse effects were also observed in cases of obesity, anemia, gestational hypertension, and maternal age over 30 years. Conclusion. Transvaginal ultrasound performed three months after CS allows identification of patients at increased risk of uterine scar deficiency. The results highlight the need for an individualized approach to the management of patients with a high risk of scar dehiscence.