Correlation between Sonographic Caesarean Section Scar Thickness and Intraoperative Appearance of Lower Uterine Segment

Abstract

Objective: Detection of the relation between transvaginal ultrasound measurement of cesarean scar thickness with intraoperative uterine scar grading assessed sonographically, and intraoperative integrity. Patients and Methods: A total of 44 pregnant women with previous CS scheduled for elective caesarean delivery at term were enrolled and subjected to pre-delivery transvaginal ultrasound examination of caesarean scar thickness and correlated with intraoperative lower uterine segment grading. Results: The best cut off value of transvaginal sonographic measurements of caesarean section scar thickness for detection of dehiscence was <3.5 mm i.e. grade III and IV with sensitivity 75%% and specificity 88.9%, positive predictive value 60% and negative predictive value 94.1%. The mean value of cesarean section scar thickness was 2.32±0.40mm for scar dehiscence group. Conclusion: Transvaginal sonographic measurements of caesarean section scar thickness had a proper sensitivity in prediction of possibility of cesarean scar dehiscence and it give an idea about risk and benefits of performing trial of labor after cesarean section.