Assessment of Uterine Scar Thickness by Ultrasonography in Women with Previous Cesarean Scar

Abstract

Objectives: To assess the uterine scar thickness by transabdominal ultrasonography among term pregnant women with previous cesarean scar.

Methodology: A descriptive cross-sectional study was done in the department of Obstetrics and Gynecology, Benazir Bhutto Hospital, Rawalpindi between June and November 2022. A total of 130 women who have previously given one birth by caesarean section between 25 to 40 years of age were included. Clinical pelvimetry and sonographic assessment of the scar was done between 37-40 weeks. The lower uterine segment thickness was measured by partial filling of the bladder to avoid interobserver variability. Measurements were taken at several points (3-4) on lower uterine, and the thinnest part was measured as scar. The complete examination of lower uterine in multiple planes was performed to find symptomless uterine dehiscence. Women underwent trial of labour was monitored by pulse, fetal heart rate via cardiotocography with progress of labour. If they had lower segment cesarean section, the status of scar noted and findings correlated with scar thickness.

Results: The patients mean age was 28.31±4.34 years. Gestational age mean was 38.57±0.96 weeks. Mean interpregnancy interval was 23.34±11.21 months. The mean uterine scar thickness was 3.68±1.47 mm. Frequency of scar dehiscence among women was found 13.1%. Frequency of dehiscence among women was found 41.5% with ≤ 2.5 mm and no woman was reported with ≥ 2.5 mm scar thickness.

Conclusion: The study concluded that the uterine scare thickness less than 2.5 mm during the labour is associated with uterine defect during a labour trial.