Risk of Scar Dehiscence in Women with Previous Cesarean Section on Ultrasonography

¹Department of Obstetrics and Gynaecology, SHKM Govt. Medical College, Nalhar (Haryana), India
²Department of Anatomy, SHKM Govt. Medical College, Nalhar, India.
³Department of Physiology, SHKM Govt. Medical College, Nalhar, India.
Corresponding Author: Pinki Rai, Department of Anatomy, SHKM Govt. Medical College, Nalhar, India, Tel: 9050675237;
Email: [email protected]

Received Date: 10 Apr 2017   
Accepted Date: 05 May 2017   
Published Date: 10 May 2017

Copyright © 2017 Pinki Rai

Citation: Malik J, Das A, Rai P and Das S. (2017). Risk of Scar Dehiscence in Women with Previous Cesarean Section on Ultrasonography. Mathews J Gynecol Obstet. 2(1): 009.

ABSTRACT

Purpose To estimate the risk of uterine dehiscence / rupture in women with previous cesarean section (CS) by comparing the thickness of lower uterine segment (LUS) and myometrium with Transabdominal (TAS) and Transvaginal sonography (TVS).
Methods In This Case - Control study in 100 pregnant women posted for elective CS (with or without previous; Group 1 and Group 2 respectively), the thickness of LUS and myometrium was measures sonographically (TAS and TVS).
Intra-operatively, LUS was graded (Grade I-IV) and its thickness was measured with calipers. The primary outcome of the study was correlative between ecgographic measurements (TAS and TVS) and features of LUS (Grades I-IV) at the time of CS. Secondary outcomes were correlation between myometrial thickness, number of previous CS, and inter-delivery interval with LUS (Grades I-IV).
Results Sonographic measurements of LUS and myometrium were significantly different between the two groups (both TAS and TVS p-value=0.000 each). However, the number of CS (p=0.440) and inter-delivery interval (p=0.062) had no statistical significant correlation with thickness of LUS.
Conclusion Sonographic evaluation of LUS scar and myometrial thickness (both with TAS and TVS) is a safe, reliable and non-invasive method for predicting the risk of scar dehiscence/rupture. Specific guidelines for TOLAC, after sonographic assessment of women with previous CS, are need of hour.

KEYWORDS

Transabdominal Ultrasonography; Transvaginal Ultrasonography; Cesarean Section; Pregnancy; Cesarean Scar.