Ultrasound Assessment of Lower Uterine Segment Thickness During Pregnancy, Labour, and the Postpartum Period

Fukuda, Misao; Fukuda, Kiyomi; Shimizu, Takashi; Bujold, Emmanuel

doi:10.1016/j.jogc.2015.12.009

Cited by 33 publications

(26 citation statements)

References 20 publications

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“…This is in accordance with Fukuda M et al, who in their study done in 2015 found out that lower uterine segment thickness decreases with gestational age and correlates strongly with intraoperative lower uterine segment thickness in women with previous caesarean section. 9 Although Ram M et al, in 2018 found in their study that gestational age at delivery was not found to be an independent risk factor for the success of VBAC. 10 In present study scar dehiscence was reported in 65% of patients with interpregnancy interval less than 18 months and in only 6.66% of patients with interpregnancy interval more than 24 months (Table 6).…”

Section: Discussionmentioning

confidence: 89%

Retrospective study to find predictive factors of scar dehiscence in previous caesarean section to prevent maternal and perinatal morbidity and mortality

Tyagi¹,

Prabhakar²,

Tyagi³

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Uterine scar dehiscence is a complication in which scar tissue remaining from previous C-section is disrupted and separated. Its incidence ranges between 0.2%-4.3% of all pregnancies with previous caesarean. It is asymptomatic in 48% of patients and thus is a serious complication because if not predicted it can lead to uterine rupture.Methods: Patients included in the study were of previous caesarean who were taken for repeat caesarean and scar dehiscence was not predicted preoperatively but seen intra-operatively. History, symptoms, signs and radiological investigations were interpreted to find out single or multiple factors responsible for scar dehiscence.Results: Incidence of scar dehiscence was found to be 8.3% .Scar dehiscence was detected in 55% of cases who were gravida 3 and above, all patients with intraoperative scar tenderness, 35% of patients with scar thickness ˂2mm, 70% cases with POG 37-40 weeks, 65% of patients with interpregnancy interval˂18 months,86.6% of patients with scar dehiscence had baby birth weight ˃3kg.Conclusions: Authors concluded that a single factor which has maximum predictive value for scar dehiscence is scar tenderness.

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Section: Discussionmentioning

confidence: 89%

Retrospective study to find predictive factors of scar dehiscence in previous caesarean section to prevent maternal and perinatal morbidity and mortality

Tyagi¹,

Prabhakar²,

Tyagi³

2019

Int J Reprod Contracept Obstet Gynecol

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“…There is still a shortage of studies describing the uterine ultrasound differences found in primiparous and multiparous patients after normal labour from the earliest puerperium until 8 weeks of postpartum period [9]. Only a few studies include Doppler measurements of uterine arteries during the normal involution period, or the scope of the examination is very narrow [1, 3, 10–14]. A longitudinal sonographic study is the best way to explore the similarities and differences that are likely to occur in primiparous and multiparous patients during puerperium.…”

Section: Introductionmentioning

confidence: 99%

Physiological Uterine Involution in Primiparous and Multiparous Women: Ultrasound Study

Paliulytė

Drąsutienė

Ramašauskaitė

et al. 2017

Obstetrics and Gynecology International

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Purpose To examine the uterine involution period after uncomplicated delivery in primiparous and multiparous women. Methods Longitudinal prospective study. Repeated parameters were measured and endometrial contents and diastolic notch were observed. Measurements of primiparous and multiparous women were carried out after labour on the 1st, 3rd, 10th, 30th, 42nd, and 60th postpartum days. The analysis was performed using SPSS version 21. Results The median uterus parameters are bigger in multiparous group in physiological puerperium, but the decreasing trend is the same. The endometrial cavity on the 10th day was significantly wider in multiparous women and mainly echo-negative view of the uterine cavity was observed. The evaluation of the uterine angle deviation changes from an extremely retroverted position to a more anteverted position. RI of the uterine artery in both groups was low immediately after labour and significantly increased one month postpartum. Notching of the uterine artery undergoes changes, but diastolic notch does not appear in all postpartum women even after two months following labour. Conclusions The puerperium period after normal vaginal delivery depends on parity. The trend of involution in primiparous and multiparous women follows a similar pattern, yet, it lasts longer in the multiparous women. Ultrasound of uterine is certainly a useful tool after labour and may be important in facilitating an early detection of postpartum uterine complications.

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“…17 A reasonable compromise consist of increased vigilance in the hour after delivery of the placenta, reserving internal palpation of the lower segment for women with signs of abnormal bleeding which was not seen in any of our patient. [18][19][20] Two factors strongly influenced the mode of delivery in this study which is:…”

Section: Discussionmentioning

confidence: 99%

A sonographic assessment of previous caesarean section scar: is a reliable safeguard for trial of labour?

Dhama

Gupta

Chaudhary

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONCaesarean section is a surgical procedure to deliver a baby through an incision in the uterus. Over the time the caesarean delivery rate has significantly increases Worldwide from 18.2% in 2002 to 30.3% in 2012. 1 As a result women presenting with pregnancy with previous C-section are also rising.Studies showed that a first successful vaginal delivery, even if instrumental, increases the chances of vaginal delivery in the subsequent pregnancy, while a first delivery by caesarean section has been associated with an increased risk of repeat caesarean Section in the subsequent deliveries.Management of a woman, who has undergone a previous caesarean section, has been a controversial topic for a long time. In parous women, previous caesarean section has been found to be the most common indication for caesarean delivery in as high as 67% cases. 2 Unsecure prediction of the integrity of the scarred LUS during labor appears to be one of the reasons for high repeat caesarean rates. Due to the fear of uterine rupture during ABSTRACT Background: Over the time the caesarean delivery rate has significantly increase worldwide from 18.2% in 2002 to 30.3% in 2012. In parous women, previous caesarean section has been found to be the most common indication for caesarean delivery in as high as 67% cases. Unsecure prediction of the integrity of the scarred LUS during labor appears to be one of the reasons for high repeat caesarean rates. The purpose of this study was to assess the usefulness of sonographic measurement of the lower uterine segment scar before labour for deciding whether it is a reliable safeguard for trial of labour or not in a woman having previous one caesarean delivery. Methods: This study was a prospective observational study, carried out on 108 pregnant women having previous one CS, gestational age >37, singleton pregnancy, cephalic presentation. Trans-abdominal USG was done to measure scar thickness. Trial of labour was given to each patient irrespective of scar thickness. Pregnancy outcome were noted in terms of successful VBAC or emergency LSCS and compared with scar thickness. Correlation between sonographic and intra-operative finding of scar were noted. Results: Result shows strong correlation between scar thickness and successful trial of labour. Scar thickness increases chances of successful vaginal deliveries. Conclusions: Sonographic assessment of previous scar has a practical application to predict the thickness and thinness of previous scar and can be taken as a reliable safeguard for trial of labour after previous cesarean but cut off value above which vaginal delivery could be considered safe is yet to be identified.

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Ultrasound Assessment of Lower Uterine Segment Thickness During Pregnancy, Labour, and the Postpartum Period

Cited by 33 publications

References 20 publications

Retrospective study to find predictive factors of scar dehiscence in previous caesarean section to prevent maternal and perinatal morbidity and mortality

Retrospective study to find predictive factors of scar dehiscence in previous caesarean section to prevent maternal and perinatal morbidity and mortality

Physiological Uterine Involution in Primiparous and Multiparous Women: Ultrasound Study

A sonographic assessment of previous caesarean section scar: is a reliable safeguard for trial of labour?

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