PDF(Pubmed)
Abstract：
OBJECTIVE: To investigate the association between caesarean scar defects and abnormal uterine bleeding through systematic literature review.
METHODS: PubMed, Web of Science, Cochrane Library and Embase databases were searched based on PRISMA 2020 to include studies exploring abnormal uterine bleeding in women with caesarean scar defects. The combined relative risk (RR) of uterine bleeding, combined prevalence of abnormal uterine bleeding and combined RR of intermenstrual uterine bleeding were calculated using a fixed- or random-effects model.
RESULTS: Ten studies involving 1,183 women with caesarean scar defects met the inclusion criteria for this study. Compared with women without caesarean scar defects, those with caesarean scar defects had a higher risk of abnormal uterine bleeding (RR: 3.22, 95% CI: 1.83-5.66) and intermenstrual bleeding (RR: 2.93, 95% CI: 1.91-4.50). The prevalence of abnormal uterine bleeding was approximately 0.46 (95% CI: 0.27-0.64), and across populations, women with a previous caesarean section who had undergone imaging specifically for gynaecological disease had a significantly higher prevalence of abnormal uterine bleeding (0.77, 95% CI: 0.65-0.89) than those with at least one caesarean Sect. (0.25, 95% CI: 0.10-0.39).
CONCLUSIONS: A significant association was observed between caesarean scar defects and abnormal uterine bleeding, with the former being a risk factor for the latter. However, previous studies have differed in the definition of caesarean scar defects and abnormal uterine bleeding, and more high-quality studies are needed to further investigate the relevant definitions and study results in the future.
METHODS: PubMed, Web of Science, Cochrane Library and Embase databases were searched based on PRISMA 2020 to include studies exploring abnormal uterine bleeding in women with caesarean scar defects. The combined relative risk (RR) of uterine bleeding, combined prevalence of abnormal uterine bleeding and combined RR of intermenstrual uterine bleeding were calculated using a fixed- or random-effects model.
RESULTS: Ten studies involving 1,183 women with caesarean scar defects met the inclusion criteria for this study. Compared with women without caesarean scar defects, those with caesarean scar defects had a higher risk of abnormal uterine bleeding (RR: 3.22, 95% CI: 1.83-5.66) and intermenstrual bleeding (RR: 2.93, 95% CI: 1.91-4.50). The prevalence of abnormal uterine bleeding was approximately 0.46 (95% CI: 0.27-0.64), and across populations, women with a previous caesarean section who had undergone imaging specifically for gynaecological disease had a significantly higher prevalence of abnormal uterine bleeding (0.77, 95% CI: 0.65-0.89) than those with at least one caesarean Sect. (0.25, 95% CI: 0.10-0.39).
CONCLUSIONS: A significant association was observed between caesarean scar defects and abnormal uterine bleeding, with the former being a risk factor for the latter. However, previous studies have differed in the definition of caesarean scar defects and abnormal uterine bleeding, and more high-quality studies are needed to further investigate the relevant definitions and study results in the future.
摘要：
目的：通过系统文献复习，探讨剖宫产瘢痕缺损与异常子宫出血的关系。
方法：PubMed，WebofScience,根据PRISMA2020搜索了Cochrane图书馆和Embase数据库，其中包括探索剖腹产疤痕缺陷妇女异常子宫出血的研究。子宫出血的综合相对风险（RR），使用固定效应或随机效应模型计算异常子宫出血的合并患病率和经期子宫出血的合并RR.
结果：涉及1,183名剖宫产瘢痕缺陷妇女的10项研究符合本研究的纳入标准。与没有剖腹产疤痕缺陷的女性相比，剖宫产瘢痕缺陷患者发生异常子宫出血(RR:3.22,95%CI:1.83-5.66)和经期出血(RR:2.93,95%CI:1.91-4.50)的风险较高.异常子宫出血的患病率约为0.46（95％CI：0.27-0.64），在不同的人群中，曾进行过专门针对妇科疾病的影像学检查的剖腹产女性异常子宫出血的患病率(0.77,95%CI:0.65~0.89)明显高于至少一次剖腹产的女性.（0.25，95%CI：0.10-0.39）。
结论：观察到剖宫产瘢痕缺陷与异常子宫出血之间存在显著关联，前者是后者的风险因素。然而,先前的研究在剖宫产瘢痕缺陷和异常子宫出血的定义上有所不同，未来需要更多高质量的研究来进一步研究相关定义和研究结果。
方法：PubMed，WebofScience,根据PRISMA2020搜索了Cochrane图书馆和Embase数据库，其中包括探索剖腹产疤痕缺陷妇女异常子宫出血的研究。子宫出血的综合相对风险（RR），使用固定效应或随机效应模型计算异常子宫出血的合并患病率和经期子宫出血的合并RR.
结果：涉及1,183名剖宫产瘢痕缺陷妇女的10项研究符合本研究的纳入标准。与没有剖腹产疤痕缺陷的女性相比，剖宫产瘢痕缺陷患者发生异常子宫出血(RR:3.22,95%CI:1.83-5.66)和经期出血(RR:2.93,95%CI:1.91-4.50)的风险较高.异常子宫出血的患病率约为0.46（95％CI：0.27-0.64），在不同的人群中，曾进行过专门针对妇科疾病的影像学检查的剖腹产女性异常子宫出血的患病率(0.77,95%CI:0.65~0.89)明显高于至少一次剖腹产的女性.（0.25，95%CI：0.10-0.39）。
结论：观察到剖宫产瘢痕缺陷与异常子宫出血之间存在显著关联，前者是后者的风险因素。然而,先前的研究在剖宫产瘢痕缺陷和异常子宫出血的定义上有所不同，未来需要更多高质量的研究来进一步研究相关定义和研究结果。
