Journal of Ultrasound in Medicine, Vol 7, Issue 7 389-393, Copyright © 1988 by American Institute of Ultrasound in Medicine
Sonography of the low transverse incision, cesarean section: a prospective study
M. E. Baker, H. Kay, B. S. Mahony, C. J. Cooper and J. D. Bowie
Department of Radiology, Duke University Medical Center, Durham, NC 27710.
Using sonography, the uterine incision site was prospectively studied in 36
asymptomatic patients, two days after cesarean section. The findings were
compared with those seen in 21 symptomatic, postcesarean patients. In the
asymptomatic patients, the incision site was visualized as an oval
symmetric region of distinct echogenicity interposed between the lower
uterine segment and the posterior wall of the urinary bladder. In eight of
the 36 asymptomatic patients, a small (less than 1.5 cm) round hypoechoic
mass was present in or adjacent to the uterine incision and distinct from
the normal incision. These probably represented insignificant hematomas. Of
the 21 symptomatic patients, 17 had either a subfascial hematoma, a
bladder-flap hematoma, or endometritis. Two were sonographically normal,
and one showed a hematoma in the paracolic gutter. In the remaining
patient, there was a 5-mm asymmetrically placed hypoechoic mass
representing an insignificant hematoma. Significant bladder-flap hematomas
were characteristically round, greater than 2 cm masses asymmetrically
placed in or adjacent to the uterine incision. Using sonography, the normal
appearance of the lower uterine incision can be distinguished from
significant hematomas.
