Does a Caesarean Section Scar Affect Placental Volume, Vascularity and Localization?
, Anda Ķīvīte-Urtāne 3,4, Pavels Domaševs 2, Laura Lūse 2, Natālija Vedmedovska 1,2 and Gilbert G. G. Donders 5,6Round 1
Reviewer 1 Report
Thank you for asking me to provide a review of this article, which has a subject of high interest nowadays, as Caesarian Sections are more and more frequent among pregnant women, due to an unexplained fear of the women to experience vaginal birth. Although it may seem easy to perform such a surgery, C-Section deliveries may cause multiple complications for the next pregnancies, from the rupture of the previous C-Section scar, to an abnormal implantation of the placenta, infertility etc.
The main purpose of the analysis was to assess the placental development deviations in the uterus with a C-Section scar by evaluating placental volume and vascular flow indexes. The study was a prospective cohort study and was conducted for a period of time between 1st January 2021 and 31st March 2022 on a total number of 221 pregnant women who met the inclusion criteria, which is quite sufficient from my point of view.
Regarding the structure and accuracy of the phrases, the manuscript has indeed well structured information, with supported evidence and well structured phrases.
The manuscript is original and well defined and so, the results provide an advance in current knowledge. The results are being interpreted appropriately and are significant, as well as are the conclusions, which are, of course, supported by the results. So the article is written in an appropriate way.
The study is correctly designed and the analysis is being performed at high standards, so the data are robust enough to draw the conclusion.
Surely the paper will attract a wide readership.
The English language is appropriate and well understandable and only has very few writting mistakes, which can easily be corrected, so that the article could be of highest quality.
I only have a few things to add in the lines below, strictly regarding the writting techniques, but it is clear that the article is completely adequate and deserves to be published:
Line 35: the scar, not „a scar”
Line 52: the development, not „development”
Line 61: fetal, not „foetal”
Line 81: fetal, not „foetal”
Line 95: „.” after „[18, 19]”
Line 103: „.” after „[20]”
Line 123: fetal, not „foetal”
Line 128: the exclusion, not „exclusion”
Line 178: was used, not „have been used”
Line 183: fetal, not „foetal”
Author Response
Dear Reviewer,
Thank you for your kind appraisal and evaluation.
We are also very grateful for pointing out the misspellings, which we have corrected.
Best regards,
Diana Bokucava
Reviewer 2 Report
Dear authors,
well done! I've found your research very interesting and the study well conducted
I would just suggest some minor revisions
1) I would suggest to add a simple table with the main results of the study to let other clinician immediately get the main points
2) would stress more within the introduction the critical role that an accurate study of the placenta has to prevent a misunderstood abnormal placentation well known condition of difficult caesarean section
would suggest to read and cite PMID: 31962259
otherwise no comment this is a very nice paper
best regards
Author Response
Dear Reviewer,
I would like to thank you for the following valuable suggestions:
Point 1: I would suggest to add a simple table with the main results of the study to let other clinician immediately get the main points
Response 1: Thank you for pointing this out. We have added the table with the main results as Table 3.
Point 2: Would stress more within the introduction the critical role that an accurate study of the placenta has to prevent a misunderstood abnormal placentation well known condition of difficult caesarean section
Response 2: Thank you for advice. We have emphasized the role of ultrasound in the diagnostics and the management of abnormal placentation and cited the article you kindly provided to us.
Best regards
Round 2
Reviewer 1 Report
Thank you for requesting to provide a review of this revised article, which has a subject of high interest.
After the corrections were made, it is clear that the article is written in a proper way.
Regarding the structure and accuracy of the phrases, the manuscript has indeed well structured information, with supported evidence and well structured phrases.
The results are being interpreted appropriately and are significant. The conclusions are supported by the results. The article is written in an appropriate way.
The study is correctly designed and the analysis is being performed at high standards, so the data are robust enough to draw the conclusion.
Surely the paper will attract a wide readership.
The English language is appropriate and well understandable.
It is clear that the article is completelly adequate and should be published.
