Prediction of Preoperative Cesarean Scar Dehiscence by Using 2D Ultrasound in Pregnant Women with Previous Cesarean Section

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Specialized Hospital, Ministry of Health, Mansoura, Egypt.

2 Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

Abstract

Background: Cesarean scar dehiscence [CSD] during subsequent pregnancy is a serious complication that can lead to uterine rupture. Identifying risk factors and allowing close monitoring could help prevent such complications. Two-dimensional [2D] ultrasound is commonly used to evaluate cesarean scars, but its predictive value for CSD is unclear.
The aim of the work: To assess the accuracy of preoperative 2D transvaginal ultrasound in predicting cesarean scar dehiscence during repeat cesarean section.
Patients and Methods: Women with a history of one prior cesarean delivery and who required repeat cesarean were recruited. Transvaginal ultrasound [TAS] was performed on all women to measure the thickness of the lower uterine segment [LUS] at 36 to 40 weeks. The grade of LUS was then detected during surgery. The ultrasound measurement was correlated with intraoperative measurements.  
Results: Lower uterine segment dehiscence stage 4 was discovered in 3 women [5%]. Ultrasonography thickness had a statistically significant negative correlation with the scar grade at a cutoff level of <1.550 mm. The US thickness had a sensitivity of 84.6% and specificity of 87.5% for predicting a grade 4 uterine scar.
Conclusion: Preoperative 2D transvaginal ultrasound appears to be a reliable method for predicting cesarean scar dehiscence prior to repeat cesarean delivery. This helps reduce complications.

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