Correlations Between Sonographically Measured Lower Segment Scar Thickness and Actual Incision Site Scar Status after Repeated Caesarean Section.

Sumbul Nafeh; Habiba Sharaf Ali; Manahil Jaffer

Author(s)

Sumbul Nafeh Ziauddin University, Karachi, Pakistan

Habiba Sharaf Ali Ziauddin University, Karachi, Pakistan

Manahil Jaffer Ziauddin University, Karachi, Pakistan

Abstract

OBJECTIVE: To verify the sonographically measured thickness of the lower uterine segment caesarean-section (LUS-CS) scar with incision site scar status in women undergoing repeated caesarean section to predict any obstetrical complication. STUDY DESIGN: A cross sectional observational study. PLACE AND DURATION: From 1st January 2016 to 30th June 2016. Department of Obstetrics & Gynecology of Zaiuddin University Hospital, Kemari Campus, Karachi METHODOLOGY: 208 patients with previous caesarean section were selected in whom Lower Uterine Segment (LUS) was measured by abdominal ultrasound scan from 36 to 38 weeks. The scar was observed visually while performing caeserian section after measuring by ultrasound and was categorized into five groups i.e Normal, Thin, Very thin, Translucent and Scar dehiscence, to find the association between scar thickness measured sonographically and visually found scar status. Also factors were observed which influence the integrity of the caesarean section scar such as parity, BMI, previous vaginal deliveries, interval between the previous and present caesarean section, and whether the present Caesarean section was done in emergency or as an elective procedure. RESULTS: Significant association was found between the Lower uterine segment measurements by trans-abdominal ultrasound during pregnancy and the status of scar at the time of delivery. 42.8% were found thin, 35.1% very thin, 7.7% translucent, 6.3% dehiscence and 8.2% were found normal. No significant association was found between the status of scar with parity, BMI and labour at previous caesarean section. Dehiscence was reported in 10.4% of women having a below average scar thickness in comparison to 3.9 % of women having an above average thickness. CONCLUSION: Sonographic LUS thickness is a strong predictor for uterine scar defect in women with prior Caesarean section. The ultrasonic measurement of thickness of the LUS (the lower uter ine segment) has a practical application in the decision on the mode of deliveries in women who had previously given birth by Caesarean section.

Publication Details

Page(s) 314-319

DOI DOI not available

Published Journal: Isra Medical Journal, Volume: 9, Issue: 5, Year: 2017

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