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Comparative Study of USG and MRI in Evaluation of Isthmocele

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Abstract

Objective

To study the presence of isthmocele in post-cesarean women using USG and MRI and its correlation with risk factors.

Method

This was a prospective observational study. A total of 90 patients were enrolled at the time of discharge of cesarean delivery and were advised to come for follow-up at 3–4 months for detection of isthmocele. A total of 82 patients reported for follow-up, and TVS and MRI Pelvis were done for visualization of isthmocele. If isthmocele was diagnosed, its correlation with risk factors was studied.

Results

On TVS isthmocele was present in 11 patients and on MRI in 16 patients. Detection rate was 77.07% in comparison with previous studies. Compared to MRI, sensitivity of USG was 68.75%; however, the specificity and positive predictive value for both were 100%. The negative predictive value for USG compared to MRI was 92.96%. Shape of the isthmocele was triangular in most women. Obesity, prior history of cesarean delivery, elective cesarean, gestational diabetes, preeclampsia and prolonged active labor were associated with development of isthmocele.

Conclusion

The study concluded that yield of diagnosis of isthmocele by MRI was better than TVS but not statistically significant. Further study with large sample size is needed to identify the best tool for diagnosis of isthmocele. Obesity, gestational diabetes, preeclampsia, prior history of cesarean, elective cesarean and prolonged active labor were associated with development of isthmocele.

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Funding

We, Taru Gupta, Dr Khushbu Singal, Dr Nupur Gupta, Dr Supreeti Kohli, Dr Monica Kanyal are submitting a manuscript titled “Comparative study of USG and MRI in evaluation of Isthmocele’ and we are responsible for disclosing all financial and personal relationships that might bias their work. We also declare that this study was conducted in a postgraduate institute and no funding was involved.

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Authors and Affiliations

  1. Department of Obstetrics & Gynaecology, ESI PGIMSR Basaidarapur, New Delhi, India

    Taru Gupta, Khushbu Singal, Nupur Gupta & Monica Kanyal

  2. Department of Radiology, ESI PGIMSR Basaidarapur, New Delhi, India

    Supreeti Kohli

Authors
  1. Taru Gupta
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  2. Khushbu Singal
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Corresponding author

Correspondence to Khushbu Singal.

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Conflict of interest

The author declares that they have no conflict of interest.

Ethical Approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national). An ethical clearance has also been taken from the institutional ethical committee.

Informed Consent

Informed Consent in Studies with Human Subjects All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study. This article does not contain any studies with animal subjects.

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Dr Taru Gupta, MS, DNB, is an Professor and Head, Department of Obstetrics and Gynaecology, ESI PGIMSR Basaidarapur New Delhi; Dr Khushbu Singal is an Post graduate student, Department of Obstetrics and Gynaecology, ESI PGIMSR Basaidarapur New Delhi; Dr Nupur Gupta, MS is an Associate Professor, Department of Obstetrics and Gynaecology, ESI PGIMSR Basaidarapur New Delhi; Dr Supreeti Kohli, MD is an Professor, Department of Radiology, ESI PGIMSR Basaidarapur New Delhi; Dr Monica Kanyal is an Post graduate student, Department of Obstetrics and Gynaecology, ESI PGIMSR Basaidarapur New Delhi.

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Gupta, T., Singal, K., Gupta, N. et al. Comparative Study of USG and MRI in Evaluation of Isthmocele. J Obstet Gynecol India 71, 292–296 (2021). https://doi.org/10.1007/s13224-021-01433-w

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  • DOI: https://doi.org/10.1007/s13224-021-01433-w

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