Location of scar after caesarean section

• Research type

  Research Study

• Full title

  Location of the scar after caesarean section.

• IRAS ID

  229897

• Contact name

  Amarnath Bhide

• Contact email

  abhide@sgul.ac.uk

• Sponsor organisation

  St Georges University of London orSt Georges University Hospitals NHS Foundation Trust

• Duration of Study in the UK

  0 years, 11 months, 31 days

• Research summary

  Placenta praevia is an abnormal implantation of the placenta close to or covering the internal cervical os. Placenta accreta is characterized by an abnormal adherence of the placenta to the basal layer of the decidua. Implantation in the myometrium is termed placenta increta. Placenta percreta is a condition when the placenta permeates the entire thickness of the uterine wall. Collectively, the conditions are termed morbidly adherent placenta (MAP). Placenta praevia and MAP are both associated with high morbidity (bleeding, surgical complications) for the mother. It has been shown that prior caesarean section is a major risk factor for both placenta praevia and MAP.
  Worldwide, an increased rate of caesarean sections is reported. Parallel to that increased rate of caesarean sections an increased incidence of MAP is noted, with all the complications (bleeding, uterus rupture, even maternal death). In particular, prior pre-labour caesarean section is associated with an increased risk for MAP compared to prior intrapartum caesarean section. We hypothesise that the reason of why women with pre-labour caesarean section are at higher risk for developing MAP compared to women with caesarean section in labour, is because their caesarean section scars are located more towards the uterine fundus. The reason is that in late labour the lower uterine segment elongates and the surgeon therefore cuts open the uterus open closer to the internal os compared to non-/early labour caesarean sections, where the lower segment is shorter. We aim to compare the location of a caesarean section scar of women after non-labour or early labour caesarean section to women with caesarean section performed late in labour (cervical dilatation of 7.0 cm or more).

• REC name

  London - Surrey Borders Research Ethics Committee

• REC reference

  17/LO/1793

• Date of REC Opinion

  4 Dec 2017

• REC opinion

  Further Information Favourable Opinion