Evaluation of Uterine Scar on Repeat Second Cesarean Section in Patients with Previous Cesarean Section

Nargis, Nazlima; Al-Mahmood, AK; Akhter, Dr Tanveer

doi:10.3329/akmmcj.v3i1.10108

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…and co-workers at Gujarat among 385 women, and Nargis N. et al among 570 women at Dhaka. 14,15 In our study, RCS was done in six women where no scar dehiscence or rupture was noted similar to the study from Ludhiana, India by Puri P. and co-workers. 16 There was high risk of morbidly adherent placenta in women with low lying placenta and previous section, so planned antepartum and intrapartum assessment is mandatory to prevent maternal mortality and morbidity.…”

Section: Discussionsupporting

confidence: 61%

Status of Scar in Repeat Cesarean Section in a Tertiary Hospital

Shrestha¹,

Shakya²,

Shrestha³

et al. 2016

J Lumbini Med Coll

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Introduction: In modern Obstetrics, with rising trends of primary Cesarean section (CS) for fetal and maternal interests, pregnancy over the scarred uterus is a challenge to all treating obstetricians. How better the cesarean scar is sutured, its exact fate in next pregnancy is still not measurable. Objective of this study was to evaluate the status of previous cesarean scar during repeat cesarean section (RCS) and calculate the maternal morbidity in those cases in a tertiary hospital. Methods: It was a descriptive, retrospective study conducted at department of Obstetrics of Lumbini Medical College Teaching Hospital. The study was conducted from 15th July 2014 to 14th July 2015. The data were retrieved from the department of Medical Records. Women undergoing RCS were enrolled. The status of scar was evaluated in terms of intact scar, scar rupture, scar dehiscence, thin lower uterine segment, scar placenta previa, and adhesions as indicator of scar integrity. Results: There were 534 (25.4%) CS among 2,098 deliveries during the study period. Ninety one (17.04%) of them were RCS. Elective RCS were 73.6% (n=67), and emergency RCS were 26.4% (n=24). Eighty two (90.1%) women had RCS once and 9 (9.9%) had RCS for second time. Scar was intact in 22 (91.6%), scar dehiscence in 1 (8.3%), scar with adhesions in 1 (8.3%) among emergency RCS and intact in 53 (91.3%) and scar with adhesions in 5 (8.7%) among elective RCS. Among nine women of two RCS, three (37.5%) had thin scar, five (62.5%) had well formed scar, seven (87.5%) had intact scar, and one (12.5%) had scar with adhesion. There was no scar dehiscence and no scar rupture in two RCS women. Adhesions were documented twice higher in women whose primary CS was undertaken outside our hospital. Placenta previa and placenta accreta each were found in two cases. Conclusion: Most of the scars of repeat Cesarean section were healthy with no scar rupture. We can consider trial of labor for scarred uterus with strict vigilance and in need, CS is always at option.

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Section: Discussionsupporting

confidence: 61%

Status of Scar in Repeat Cesarean Section in a Tertiary Hospital

Shrestha¹,

Shakya²,

Shrestha³

et al. 2016

J Lumbini Med Coll

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“…Thus some women with scar complications did not present with scar tenderness. 14 Rubina et al in a study of 120 women found three cases of scar tenderness of which one had a ruptured uterus at cesarean. 15 The only other study that was available was one of 99 women, where 1 woman had scar tenderness with intact scar while one case of dehiscence of scar did not have scar tenderness.…”

Section: Discussionmentioning

confidence: 97%

Is scar tenderness a reliable sign of scar complications in labor?

Gaikwad

Aggarwal

Bannerjee

et al. 2012

Int J Reprod Contracept Obstet Gynecol

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“…A group of investigators concluded that among women with a previously scarred uterus, induction of labour is associated with an increased risk of rupture uterus compared with spontaneous labour (2.3% vs 0.7% p=0.001). 2 The present study was done to know the maternal and fetal outcome in patients with previous cesarean section and those required repeat CS.…”

mentioning

confidence: 99%

Study of feto-maternal outcome in previous cesarean section

Chiniwar

2018

Int J Reprod Contracept Obstet Gynecol

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Background: There is increase in number of primary cesarean sections, leading to more number of women facing the issue of mode of delivery in the current pregnancy. There are reports about success of vaginal birth after cesarean section as well as complications such as scar dehiscence, rupture of uterus, poor maternal and fetal outcome.Methods: A prospective study was done for a period of 1 yr and 9 months at Cheluvamba Hospital attached to Govt Medical College Mysore from October 99 to June 2000. Data regarding previous cesarean section was collected, clinical findings during the present pregnancy were noted.Results: During the study period there were 942 women admitted with previous history of cesarean section. Elective repeat cesarean section was done for 530 cases and trial of labour after cesarean section was planned for 412 cases. Successful vaginal delivery was conducted in 311 cases. Repeat emergency cesarean section was done for 96 cases due to failed trial of labour. Maternal morbidity such as adhesions was seen in 11.25% and obliteration of U V fold in 7.92% of cases. Maternal mortality was seen in 0.15%. Perinatal morbidity was seen in 3.32%, perinatal mortality in 3.96%.Conclusions: With increasing proportion of women with previous cesarean sections, it is essential to counsel these women during trial of vaginal delivery in well equipped hospitals. It is worth to reduce primary cesarean section to avoid complications in consequent pregnancies. Proper and timely decision for repeat cesarean sections will reduce fetal and maternal morbidity and mortality.

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Evaluation of Uterine Scar on Repeat Second Cesarean Section in Patients with Previous Cesarean Section

Abstract: only marginally increased among women undergoing a trial of labor 2 than among those undergrant an elective repeat cesarean section (0.4% vs 0.2% OR=2

Cited by 3 publications

References 11 publications

Status of Scar in Repeat Cesarean Section in a Tertiary Hospital

Status of Scar in Repeat Cesarean Section in a Tertiary Hospital

Is scar tenderness a reliable sign of scar complications in labor?

Study of feto-maternal outcome in previous cesarean section

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