Diagnostic Accuracy of Lower Uterine Segment Scar Thickness ≤1.6mm in Prediction of Scar Dehiscence in patients
Fiza Asif, Sobia Zafar, Tehmina Zafar, Tayyaba Majeed, Zahid Mahmood
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ABSTRACT
Background: Cesarean section uterine scar dehiscence
(CSD) is a rare but notable complication of Lower segment cesarean section
(LSCS) surgery. The cause for a uterine scar dehiscence is based on the
etiology behind the uterine scar defect or any event that would predispose the
cesarean scar to dehisce. Globally accepted option for assessing the CS scar is
transvaginal ultrasonography of the non-pregnant uterus.
Objective: To determine the diagnostic accuracy of lower
uterine segment scar thickness≤1.6mm in the prediction of scar dehiscence in
patients with previous one LSCS who are undergoing repeat LSCS after trial of
labour taking intraoperative findings as gold standard.
Material and methods: This cross sectional study was
conducted in Services Hospital, Lahore for 6 months. The Non probability
consecutive sampling technique was used to include women with previous one LSCS
at 36-38 weeks were asked to get their TVS done for scar thickness. Women with
scar thickness≤1.6mm and scar thickness>1.6mm were identified. Their
intraoperative findings of scar dehiscence were confirmed. All the data was
entered and analyzed on SPSS version 20.
Results: The mean age of patients was 29.87±6.07
years. The emergency LSCS was done in 599(49.1%) patients and elective LSCS was
done in 621(50.9%) patients. The sensitivity, specificity & diagnostic
accuracy of TVS was 98.31%, 99.05% & 98.69% respectively.
Conclusion: According to our study results the TVS for
uterine scar is a very useful and effective tool in the prediction of scar dehiscence
in patients with previous one LSCS taking intraoperative findings as gold
standard.
Keywords: Transvaginal sonography, TVS, Uterine, Scar,
dehiscence, LSCS, Intraoperative