Feasibility of prediction of cesarean section scar dehiscence in the third trimester by three-dimensional ultrasound

Mansour, Ghada M.; El-Mekkawi, Sherif F; Khairy, Hassan Tawfik; Mossad, Asmaa E M

doi:10.3109/14767058.2014.938626

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…The nine studies that were excluded either used a predefined cut‐off value, or did not include sufficient information to construct 2 × 2 tables with true positives, false positives, true negatives and false negatives from the information provided in the paper. Two studies were excluded because they used three‐dimensional ultrasound . All included studies measured the lower uterine segment by ultrasound at term, with a partially full or full bladder, in either the sagittal or transverse scanning plane.…”

Section: Methodsmentioning

confidence: 99%

Sonographic lower uterine segment thickness after prior cesarean section to predict uterine rupture: A systematic review and meta‐analysis

Swift

Shah

Farine

2019

Acta Obstet Gynecol Scand

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Abbreviations: SROC, summary receiver-operating characteristics; TOLAC, trial of labor after cesarean section; VBAC, vaginal birth after cesarean section. AbstractIntroduction: Cesarean section rates are increasing with a decrease in the rate of trial of labor after cesarean section. The objective of this study was to systematically review the predictive characteristics of sonographic measurement of lower uterine segment thickness for uterine rupture during labor. Material and methods:The review was carried out in agreement with PRISMA and SEDATE guidelines. MEDLINE, EMBASE, ClinicalTrials.gov and Cochrane Library were searched from 1990 until November 2018. Quality of included studies was assessed using the QUADAS-2 tool. Data were extracted to construct 2 × 2 tables from each study comparing ultrasound measurement with uterine defect at time of delivery. The data were plotted as a summary receiver-operating characteristic (SROC) curve using the hierarchical SROC model. Results: Twenty-eight observational cohort studies met the selection criteria for inclusion. Sonographic lower uterine segment thickness was measured at a gestational age of 36-40 weeks in women with a previous cesarean section. The risk of bias and concerns regarding applicability were low among most studies. The sonographic measurement was correlated with either delivery outcome or lower uterine segment thickness at the time of repeat cesarean section. The cut-off value for lower uterine segment thickness ranged from 1.5 to 4.05 mm across all studies. An association between thin lower uterine segment measurement and uterine dehiscence and uterine rupture was shown in 27 and four studies, respectively. Nineteen studies were included in a meta-analysis with a subgroup analysis by ultrasound methodology. In the subgroup using the ultrasound methodology associated with uterine rupture, the cutoff value is more precise (2.0-3.65 mm) among these 12 studies. There were 18 cases (1.0%) of uterine rupture, 120 (6.6%) of uterine dehiscence and 1674 (92.4%) women with no uterine defect. The SROC curve showed a sensitivity of 0.88 (95% CI 0.83-0.92) and specificity of 0.77 (95% CI 0.70-0.83). The negative likelihood ratio was 0.11 (95% CI 0.08-0.16) and the diagnostic odds ratio was 34.0 (95% CI 18.2-63.5). Conclusions:Lower uterine segment thickness >3.65 mm, measured using a standardized ultrasound technique, is associated with a lower likelihood of uterine rupture. | 831SWIFT eT al.

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Section: Methodsmentioning

confidence: 99%

Sonographic lower uterine segment thickness after prior cesarean section to predict uterine rupture: A systematic review and meta‐analysis

Swift

Shah

Farine

2019

Acta Obstet Gynecol Scand

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“…Three‐dimension ultrasound is useful in the evaluation of a cesarean scar defect, as it can demonstrate the location, shape, and size of the defective scar more precisely. This might be due to the use of a multiplanar display (which permits simultaneous longitudinal, transverse, and coronal views) and their surface reconstruction, which cannot be obtained through 2D ultrasound .…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of a defect in the uterine wall using 3D ultrasound in the 16th week of gestation

Cajal

Fernández

2017

Clinical Case Reports

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Rupture of the Uterus Scarred Due to Previous Caesarean Section

Dorairajan

2016

Ruptured Uterus

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Feasibility of prediction of cesarean section scar dehiscence in the third trimester by three-dimensional ultrasound

Abstract: Three-dimensional ultrasound is useful in prediction of dehiscent scars during pregnancy with perfect sensitivity. Machines with the availability of C dissection in the multiplanar view are more useful in this field.

Cited by 4 publications

References 12 publications

Sonographic lower uterine segment thickness after prior cesarean section to predict uterine rupture: A systematic review and meta‐analysis

Sonographic lower uterine segment thickness after prior cesarean section to predict uterine rupture: A systematic review and meta‐analysis

Diagnosis of a defect in the uterine wall using 3D ultrasound in the 16th week of gestation

Rupture of the Uterus Scarred Due to Previous Caesarean Section

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