Association of uterine wall thickness with pregnancy outcome following uterine-sparing surgery for diffuse uterine adenomyosis

Aust N Z J Obstet Gynaecol. 2016 Feb;56(1):88-91. doi: 10.1111/ajo.12419. Epub 2015 Oct 30.

Abstract

Background: The risk of uterine rupture is a major concern for women who become pregnant after undergoing an adenomyomectomy.

Aims: The aim of this study was to investigate the association of uterine wall thickness with pregnancy outcome.

Materials and methods: Uterine wall thickness was measured using sonography and/or magnetic resonance imaging in 23 pregnant women who underwent uterine-sparing surgery for diffuse uterine adenomyosis prior to conception.

Results: Of the 23 women, 10 (43.5%) had an early miscarriage and 13 (56.5%) proceeded to delivery. Of the ten early miscarriage cases, two had a uterine rupture caused by excision of the uterine wall to within 7 mm.

Conclusions: Wall thickness of the excised uterus was highly associated with uterine rupture. We concluded that optimum wall thickness for conception and preventing uterine rupture during pregnancy may range from 9 to 15 mm.

Keywords: adenomyosis; conservative surgery; ultrasonography.

MeSH terms

  • Abortion, Spontaneous / etiology*
  • Adenomyosis / pathology
  • Adenomyosis / surgery*
  • Adult
  • Female
  • Gynecologic Surgical Procedures*
  • Humans
  • Magnetic Resonance Imaging
  • Postoperative Complications / etiology*
  • Pregnancy
  • Pregnancy Outcome
  • Risk Factors
  • Ultrasonography, Prenatal
  • Uterine Rupture / etiology*
  • Uterus / diagnostic imaging
  • Uterus / pathology*
  • Uterus / surgery