Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Cesarean Section and Its Impact on Uterine Artery Resistance and the Risk of Pre-eclampsia in Subsequent Pregnancies

Authors
Neda Hashemi 1
Arash Mohazzab 2
Maryam Moshfeghi 3
Samaneh Rokhgireh 1
Roya Derakhshan 1
Nasrin Sanaei Nasab 4
1 Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
2 School of Public Health, Iran University of Medical Sciences, Tehran, Iran
3 Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
4 Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
10.18502/jri.v25i3.17015
Abstract
Background: The purpose of the current study was to compare the color Dop-pler findings of uterine arteries and perinatal outcomes in pregnant women with and without previous cesarean section (C/S). Methods: This cohort study enrolled 308 pregnant women aged 20-35 without underlying diseases, with at least one previous pregnancy and childbirth. The participants were divided into two groups: 154 women without C/S and 154 women with C/S. Baseline data were collected, followed by uterine artery Dop-pler scans. Then, the perinatal outcomes, including pre-eclampsia, intrauterine growth restriction (IUGR), premature delivery, and birth weight were evaluated. Results: The average age of patients in the C/S group was 30.46±3.81, which was significantly higher than the non-C/S group (28.86±4.64). It was found that uterine artery resistance was higher in women with C/S history (1.11±0.44, p<0.001) compared to those without (1.00±0.37, p<0.001). Pre-eclampsia inci-dence was also higher in C/S group (16.1%, p=0.042) compared to non-C/S group (9.1%, p=0.042). The incidence of preterm birth in the C/S group (p=0.209), the incidence of IUGR (p=0.791), and the average birth weight (p=0.291) in the two groups did not differ significantly. The average gestational age in the C/S group was 37.54±1.4, and in the non-C/S group was 38.01±1.99 weeks. The results were not affected by potential confounders such as age, the time interval between pregnancies, and also body mass index. Conclusion: Previous cesarean section can significantly increase the uterine ar-tery resistance in subsequent pregnancy.
Keywords
Cesarean section
Color Doppler ultrasonography
Pre
Eclampsia
Uterine Artery
Uterine artery resistance
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Journal of Reproduction & Infertility
Volume 25, Issue 3
Summer 2024
Pages 211-218