Effective anatomical and functional status of the lower uterine segment at term: estimating the risk of uterine dehiscence by ultrasound

Sonographic Prediction of Scar Dehiscence in Women with Previous Cesarean Section

“…In our study, women with interdelivery interval less than 18 months (n = 7/50), when compared with other women in group 1 with respect to LUS grades II-IV, approached significance (p = 0.062). This observation is contrary to the observation of other investigators [10,14]. This could be probably due to less number of women (n = 7) with short inter-delivery interval in group 1.…”

“…In our study, women with previous two CS (in group 1) when compared with respect to LUS grades I & II and III & IV between themselves (as shown in Table 5) had no statistically significant difference (p value = 0.440), similar to observation of Gizzo et al [10].…”

“…Hence we propose, 3.65 mm of LUS thickness as measured by TAS to be a safe limit above which VBAC can be safely offered. Sonographic measurement of thickness of myometrium has been analyzed by Asakura et al [11] and Gizzo et al [10]. We observed statistically significant correlation between thickness of myometrium as measured by TAS and TVS (p = 0.000) in women with LUS grades I & II and III & IV, (as shown in Table 5).…”

“…The risk of scar dehiscence/rupture has been directly related to the thinning of LUS [8]. However, there is controversy over the thickness of LUS above which TOLAC can be offered safely [6,[8][9][10]. Also, Asakura et al have proposed myometrial thickness as an alternative to LUS thickness for predicting the risk of scar dehiscence/ rupture [11].…”

“…With different cut off for critical values of thickness of LUS and myometrium in different studies [8][9][10][11], specific guidelines regarding the measurement technique of LUS by TAS and TVS, critical thickness of LUS and myometrium for evaluation of LUS is need of the hour to save many pregnant women and babies from significant morbidity and mortality.…”