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

Neda  Hashemi; Arash  Mohazzab; Maryam  Moshfeghi; Samaneh  Rokhgireh; Roya  Derakhshan; Nasrin Sanaei  Nasab

doi:10.18502/jri.v25i3.17015

Neda Hashemi Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
Arash Mohazzab School of Public Health, Iran University of Medical Sciences, Tehran, Iran
Maryam Moshfeghi Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute, Tehran, Iran
Samaneh Rokhgireh Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
Roya Derakhshan Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
Nasrin Sanaei Nasab Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran

DOI: https://doi.org/10.18502/jri.v25i3.17015

Keywords: Cesarean section, Color doppler ultrasonography, Pre-eclampsia, Uterine artery resistance, Uterine artery.

Abstract

Background: The purpose of the current study was to compare the color Doppler 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 Doppler 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 incidence 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 artery resistance in subsequent pregnancy.