Ultrasound Predictability Of Lower Uterine Segment Cesarean Section Scar Thickness

Das²,

Int J Reprod Contracept Obstet Gynecol

2023

Background: Caesarean section is an operative process whereby the fetuses after the end of 28th weeks are delivered through an incision on the abdominal and uterine wall. This excludes delivery through an abdominal incision where the fetus lying free in the abdominal cavity following uterine rupture or in secondary abdominal pregnancy. The first operation carried out on a patient is referred to as an primary caesarean section. When the operation is carried out in subsequent pregnancies, it is referred to as repeat caesarean section. Caesarean section is used in cases where vaginal delivery is not either feasible or would impose undue risks on mother or baby. The aim of the study to assess the Relationship of Scar Tenderness with Scar Integrity at repeat caesarean section. Methods: This is an observational study. The study used to be carried out in the admitted patient’s Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh. The duration of the period from April 2017 to October 2017. Results: This study shows that the according to age of 50 Patients aged 20 to 35 years. Here out of 50 mothers the highest 23(46%) mothers belonged to 21-25 years age group. Subsequently, 15(30%), 9(18%), 2(4%) and 1(2%) belonged to 26-30 years, ≤20 years, 31-35 years and >35 years respectively. The mean age of the respondents was 23.16±5.79 (age range: 17-38) years. Conclusions: The scar complications are highly associated with the intensity of scar tenderness. Henceforth, it can be concluded here that scar tenderness is a vital factor responsible for scar complications.

Section: Discussionmentioning

confidence: 99%

Clinical study on the relationship of scar tenderness with scar integrity at repeat caesarean section

Das²,

Int J Reprod Contracept Obstet Gynecol

2023

“…In subsequent pregnancies, thin LUS is likely to rupture. 12,13 According to Jordans et al, there is an inverse relationship between LUS thickness and scar rupture, with a LUS thickness of 3.5mm being protective against uterine rupture. 14 A meta-analysis found a strong relationship between the degree of LUS thinning measured near term and the risk of uterine scar defect at birth.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Assessment of Cesarean Section Scar and its Correlation to Intraoperative Scar Status

Pario¹,

Omer²,

Abbasi³

et al. 2022

PJMHS

Background and Aim: In the past decades the rate of cesarean sections has increased enormously, there are many indications for cesarean section like placenta previa, labor dystocia, presumed fetal distress, fetal malpresentation, multiple gestation, and suspected fetal macrosomia, but the commonest reason for performing a cesarean is a previous cesarean birth .The present study aimed to compare the sonographically measured lower uterine scar with actual status of scar at the time of operation. Methodology: The descriptive cross-sectional study was conducted on 150 female patients who presented to Obstetrics department of Creek general hospital, affiliated with UMDC from August 2021 to January 2022. The Inclusion Criteria was: females with singleton pregnancy with history of previous single caesarian section, vertex presentation and gestational age 36-40 weeks. While women with multiple gestations, placenta previa, polyhydramnios or any uterine abnormality were excluded. Results: The overall mean of age, gestational age, parity and fetal weight were 28.22±4.59 years, 37.60±0.78 weeks, 1.73±0.94 and 2.75± 0.47 kg respectively. Significant association was observed between lower uterine segment measurements by Sonographic scar thickness during pregnancy and intra-operative scar findings at the time of delivery (p-value< 0.05). Conclusion: The present study found that sonographically measured lower uterine scar thickness is a solid predictor for scar defect in women with previous cesarean section. As a result, we can conclude that sonographic measurement of lower uterine segment thickness is a reliable tool for assessing scar status and deciding which women should be given a vaginal delivery trial. Keywords: Previous Caesarean Section, Lower uterine scar, Sonography

“…Some authors report that a distance of 3.1 to 5.1 mm from the bladder wall to the amnion has a 96% sensitivity and a 63% specificity for the occurrence of a uterine defect (dehiscence, rupture). There is insufficient evidence to recommend the routine ultrasound assessment of uterine scar integrity [ 21 , 22 ]. The cut-off value for the thickness of the uterine scar on the lower uterine segment measured by transvaginal sonography is not established.…”

Section: Tolac – Between Risk and Benefitsmentioning

confidence: 99%

The urological complications of vaginal birth after cesarean (VBAC) – a literature review

et al. 2021

The appearance of urological complications is a major problem in obstetrics and gynecologic surgery; the bladder is the most common damaged organ. Due to a continuous increase in the rate of cesareans, the incidence of urologic complications will be potentially higher. We reviewed the most important risk factors for urinary tract injury and analyzed the strategies necessary to avoid these situations during vaginal birth after cesarean (VBAC). The risks and benefits of VBAC should be balanced before deciding the mode of delivery.