Uterine Scar Dehiscence in Elective Versus Emergency Caesarean Section

Abstract

Objective: To determine the incidence and the associated factors of uterine scar dehiscence in women undergoing elective versus emergency caesarean section.

Methodology: This case series was conducted in a tertiary care hospital. All patients who underwent lower segment caesarean section either due to elective or emergency indications at more than 28 weeks of gestation in which intra-operative finding of scar dehiscence was present were included in this study. Data was collected on a structured proforma.

Results: The total number of women with findings of intra-operative scar dehiscence were 93. Total number of caesareans conducted till completion of sample size were 504; elective caesareans were 283 (56.1%), and 221(43.9%) were emergency caesareans. Incidence of uterine scar dehiscence in women with previous caesarean sections was 18.4%; 17.6% in elective cases and 24.4% in emergency lower segment caesarean sections. Moreover, the incidence of scar dehiscence was higher in patients who previously underwent caesarean section due to an emergency indication as compare to previous elective caesarean (p=0.00). Uterine scar dehiscence was more in patients with higher order previous caesareans in cases of elective caesareans while more in Previous 1 caesarean in cases of emergency caesarean (p=0.01). Moreover, lesser the inter pregnancy interval (1 year) higher the incidence of scar dehiscence in both cases of emergency and elective caesareans (p=0.04).

Conclusion: Incidence of scar dehiscence is quite high in both emergency as well as in elective repeat lower segment caesarean sections. Previous emergency caesarean and interpregnancy interval of one year, number of previous caesareans, and gestational age are significantly associated with scar dehiscence.