TY - JOUR
T1 - Ultrasound evaluation of scar thickness for prediction of uterine dehiscence in term women with previous caesarean sections
AU - Afzal, Shaista
AU - Masroor, Imrana
AU - Amin, Ahsun
AU - Majeed, Aiman
N1 - Publisher Copyright:
© 2024, Professional Medical Publications. All rights reserved.
PY - 2024/8
Y1 - 2024/8
N2 - Objective: To determine the role of ultrasound in evaluation of scar thickness for prediction of uterine dehiscence. Method: This retrospective cross-sectional study was conducted in the Radiology department of Aga Khan University Hospital from 1st July to 31st December 2021 after approval from the University Ethic Committee. In this study pregnant women 18 to 40 years with a live singleton fetus with vertex presentation, at term, with history of prior caesarean section and availability of medical record were included. Using a curvilinear ultrasound transducer with optimally distended urinary bladder, the myometrial thickness was measured in the sagittal plane. The intraoperative visual findings of the lower uterine segment outcome at the time of C-section were recorded and categorized into two groups i.e., with and without dehiscence for statistical analysis. Results: A total of 126 women were included. The mean age of the study participants was 29.8±4.1. The median gestational age was 35 (34-37) weeks. The highest AUC 0.58 was recorded for the scar thickness of ≤2.5mm with a sensitivity, specificity, PPV and NPV of 80.9%, 36.4%, 36.3% and 80.8% respectively. Similarly, the AUC for the scar thickness of ≤2mm was 0.55 with a sensitivity, specificity, PPV and NPV of 93%, 18.2%, 18.2% and 93% respectively. Conclusion: Transabdominal Sonography is a safe technique to determine the LUS thickness during antenatal ultrasound at term. A cutoff value of ≤2mm showed a high sensitivity and negative predictive value of 93% for evaluating the risk of uterine dehiscence.
AB - Objective: To determine the role of ultrasound in evaluation of scar thickness for prediction of uterine dehiscence. Method: This retrospective cross-sectional study was conducted in the Radiology department of Aga Khan University Hospital from 1st July to 31st December 2021 after approval from the University Ethic Committee. In this study pregnant women 18 to 40 years with a live singleton fetus with vertex presentation, at term, with history of prior caesarean section and availability of medical record were included. Using a curvilinear ultrasound transducer with optimally distended urinary bladder, the myometrial thickness was measured in the sagittal plane. The intraoperative visual findings of the lower uterine segment outcome at the time of C-section were recorded and categorized into two groups i.e., with and without dehiscence for statistical analysis. Results: A total of 126 women were included. The mean age of the study participants was 29.8±4.1. The median gestational age was 35 (34-37) weeks. The highest AUC 0.58 was recorded for the scar thickness of ≤2.5mm with a sensitivity, specificity, PPV and NPV of 80.9%, 36.4%, 36.3% and 80.8% respectively. Similarly, the AUC for the scar thickness of ≤2mm was 0.55 with a sensitivity, specificity, PPV and NPV of 93%, 18.2%, 18.2% and 93% respectively. Conclusion: Transabdominal Sonography is a safe technique to determine the LUS thickness during antenatal ultrasound at term. A cutoff value of ≤2mm showed a high sensitivity and negative predictive value of 93% for evaluating the risk of uterine dehiscence.
KW - Caesarean section
KW - Lower uterine scar thickness
KW - Ultrasound
KW - Uterine dehiscence
UR - http://www.scopus.com/inward/record.url?scp=85197459424&partnerID=8YFLogxK
U2 - 10.12669/pjms.40.7.8712
DO - 10.12669/pjms.40.7.8712
M3 - Article
AN - SCOPUS:85197459424
SN - 1682-024X
VL - 40
SP - 1361
EP - 1366
JO - Pakistan Journal of Medical Sciences
JF - Pakistan Journal of Medical Sciences
IS - 7
ER -