Background: Management of a woman who has undergone a previous cesarean section, has always been a controversial topic, with the inability to precisely confirm the integrity of the scarred lower uterine segment (LUS) being the indication of repeat cesarean section. The objective of this study is to evaluate the accuracy of ultrasonography (USG) in determining the LUS thickness in women with previous cesarean section (CS) and to assess its usefulness in predicting the risk of uterine rupture during a trial of vaginal birth.Methods: A prospective study was conducted on 100 women between 37 to 40 weeks of gestation with a previous CS and 100 primigravidae women serving as control. Thickness of LUS was measured by transabdominal USG. The decision for mode of delivery was based purely on obstetric ground. Patients undergoing CS were considered for analysis.Results: Mean LUS thickness was higher in the control group. Seventy-one patients of control group underwent repeat CS, in which 47 (66.1%) had normal intraoperative finding. 24 (33.7%) had abnormal LUS intraoperatively (LUS thinning). Of these, 20 (28.6%) showed abnormal LUS on USG (<5mm), but 4(5.6%) had normal ultrasonographic finding. Sensitivity, specificity, positive and negative predictive value of ultrasonographic evaluation were found to be 100%, 83.3%, 92% and 100% respectively.Conclusions: Prenatal scar assessment by USG is useful in evaluation of previous cesarean scar and in most cases a near accurate evaluation was possible.
Background: The Pap smear is a reliable, inexpensive and effective screening test for cervical cancer; the second most common cancer among women worldwide. We aimed to determine women’s knowledge, attitudes and practice towards Pap smear and barriers for the screening in a public hospital.Methods: It was a hospital based cross sectional study on 300 women who were interviewed face-to-face with a structured questionnaire regarding their socio demographic features (8 questions), knowledge (20 questions), attitudes (7 statements) and practice (undertook test or not) towards Pap smear.Results: A total of 320 women were approached for interview of which 300 responded of which 33.33% had heard of cervical cancer. At least one symptom and one risk factor were known to 13.33% and 20% participants. Only 31.33% participants had heard, and 6.67% actually underwent screening test, however, 76.25% of the participants expressed a favourable attitude for screening.Conclusions: Education level influences attitude towards screening and actual practice depends on age, income, and marital status. This study shows that despite the fact that women had suboptimal level of knowledge regarding cervical cancer, their attitude is favourable for screening. The knowledge and practice of women was inadequate and needs to be promoted.
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