Search

Objectives: To examine the influence of maternal pre-pregnancy body weight on fetomaternal outcomes in twin pregnancies. Study design: Retrospective study. Setting: Department of Obstetrics and Gynecology, Buergerhospital Frankfurt Population: 2,449 women delivering twins between 2005 and 2020 at the Buergerhospital Frankfurt. Methods: The mothers were categorized according to their pre-gravid body mass index into underweight, normal weight, overweight, obese, and obesity classes I – III. Main outcome measures: Gestational diabetes mellitus (GDM), preeclampsia/HELLP syndrome, intrauterine death (IUD), cesarean section or vaginal delivery, wound healing disorders, postpartum hemorrhage (PPH), uterine atony, preterm birth, birth weight discordance, admission to the neonatal intensive care unit (NICU), pH of the umbilical artery, and a 5’-APGAR score

Purpose The aim of this study is to utilize the Manchester scar scale (MSS) and ultrasound in investigating the association between uterine wall defects and cutaneous scar characteristics after cesarean section (CS). Methods This is a prospective cohort study. The degree of myometrial loss was quantified by calculating a residual myometrial thickness (RMT) ratio as a percentage of RMT to the pre-cesarean anterior uterine wall thickness. Cutaneous scar assessment was performed according to the MSS. Spearman’s correlation and the Kruskal–Wallis test with a cut-off value of p Results Two hundred forty seven women, of which 2.4% had an Asian, 3.6% an Afro-American, 82% a Caucasian and 12% a Mediterranean background, were recruited. The RMT ratio ranged between 11.9 and 100% with a median of 55.8% and an average of 56%. MSS scores ranged from 4 to 13 with a median of 5 and an average of 6. Spearman’s correlation between MSS and RMT ratio show a rho of − 0.01 with a p value of 0.8. The correlation between MSS and RMT ratio within the four ethnical groups showed a p value between 0.3 and 0.8 and a rho between 0.8 and − 0.8. The Kruskal–Wallis test showed an eta2 of 0.13 and a p value of 0.0002 for the effect of ethnicity on MSS and an eta2 of 0.009 and a p value of 0.68 for the effect of ethnicity on the RMT ratio. Conclusion CS laparotomy scars heal differently between ethnical groups, but generally with satisfying results. Ethnicity does not affect myometrial healing and scar appearance does not reflect myometrial healing after CS. Thus, separate uterine sonographic assessment is recommended.