Jyoti Malik1 , Ashima Das2 , Pinki Rai2 *, Sibadatta Das3
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.
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.
Transabdominal Ultrasonography; Transvaginal Ultrasonography; Cesarean Section; Pregnancy; Cesarean Scar.