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The amenorrhea as a protective factor for healing of hysterotomy — a retrospective analysis one year postpartum
, 1, 1, 1, 1
Affiliations- 3rd Faculty of Medicine, Institute for the Care of Mother and Child, Charles University, Prague, Czech Republic
open access
Abstract
Objectives: The good healing of the hysterotomy after cesarean section is important for subsequent pregnancies. However, the factors which improve this healing have not been completely described, yet. In this study, we focused on factors which may affect healing of hysterotomy within one year after delivery, such as menstruation, breastfeeding, and the use of the contraception.
Material and methods: Following delivery, total of 540 women were invited for three consecutive visits at six weeks, six months, and 12 months postpartum. The presence of menstruation, frequency of breastfeeding and contraception use were recorded. The scar was evaluated by vaginal ultrasound as already described. The impact of menstruation, breastfeeding, and contraception method on presence of niche was evaluated.
Results: The presence of menstruation increased odds to have niche by 45% (CI 1.046–2.018, p = 0.026). Secondarily, our results demonstrated a statistically significant protective effect of breastfeeding on the incidence of niche with OR 0.703 (CI 0.517–0.955, p = 0.024). Breastfeeding decreases odds to have niche by 30%. Also, the use of gestagen contraception lowered the odds by 40% and intrauterine device (IUD) or combine oral contraceptive (COC) by 46.5%. The other possibly intervening factors were statistically controlled.
Conclusions: Amenorrhea, breast-feeding and progesterone-contraceptive decreases the risk of uterine niche within one year follow up.
Abstract
Objectives: The good healing of the hysterotomy after cesarean section is important for subsequent pregnancies. However, the factors which improve this healing have not been completely described, yet. In this study, we focused on factors which may affect healing of hysterotomy within one year after delivery, such as menstruation, breastfeeding, and the use of the contraception.
Material and methods: Following delivery, total of 540 women were invited for three consecutive visits at six weeks, six months, and 12 months postpartum. The presence of menstruation, frequency of breastfeeding and contraception use were recorded. The scar was evaluated by vaginal ultrasound as already described. The impact of menstruation, breastfeeding, and contraception method on presence of niche was evaluated.
Results: The presence of menstruation increased odds to have niche by 45% (CI 1.046–2.018, p = 0.026). Secondarily, our results demonstrated a statistically significant protective effect of breastfeeding on the incidence of niche with OR 0.703 (CI 0.517–0.955, p = 0.024). Breastfeeding decreases odds to have niche by 30%. Also, the use of gestagen contraception lowered the odds by 40% and intrauterine device (IUD) or combine oral contraceptive (COC) by 46.5%. The other possibly intervening factors were statistically controlled.
Conclusions: Amenorrhea, breast-feeding and progesterone-contraceptive decreases the risk of uterine niche within one year follow up.
Keywords
cesarean section; uterus; contraception; niche; breastfeeding
About this articleTitle
The amenorrhea as a protective factor for healing of hysterotomy — a retrospective analysis one year postpartum
Journal
Issue
Article type
Research paper
Pages
972-977
Published online
2023-06-01
Page views
576
Article views/downloads
316
DOI
Pubmed
Bibliographic record
Ginekol Pol 2023;94(12):972-977.
Keywords
cesarean section
uterus
contraception
niche
breastfeeding
Authors
Hynek Herman
Petr Velebil
Iva Urbankova
Petr Krepelka
Michal Emingr
Lucie Hympanova
Ladislav Krofta
Jiri Hanacek
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