Intraoperative Findings During Caesarean Sections for Suspected Scar Dehiscence

Abstract

Objective: To investigate intraoperative findings during caesarean sections in cases with suspected scar dehiscence.

Methodology: This retrospective study was done in the Obstetrics and Gynecology departments of Rahbar Medical College and Azra Naheed Medical College for one year, from January 2022 to December 2022. Women aged more than 18 years with clinical signs of scar dehiscence or suspicion based on their medical history, and who were scheduled for a caesarean section were included. Scar dehiscence was defined as the separation of the previous uterine incision from a C-section. It was confirmed during the current caesarean section if a gap or opening was observed at the site of the previous uterine incision. SPSS version 26 was used for data analysis.

Results: A total of 72 participants were included in the study, with an average age of 28.13 years. According to the intraoperative findings 29.2% cases had an intact scar, scar dehiscence was observed in 13.9% of cases and interestingly none of the cases had a rupture scar. Scar dehiscence was found to be statistically significant in cases with multiple previous c-sections (p=0.001), but it was statistically insignificant in relation to the pregnancy interval (p=0.140). Conversely, the presence of an intact scar was statistically insignificant when considering the number of c-sections, while it showed significance in cases with a short pregnancy interval (p=0.010).

Conclusion: According to the intraoperative findings, scar dehiscence was detected in 13.9% of cases, while scar integrity was observed in 29.2% of women suspected of having scar dehiscence, with a significant association with the number of previous C-sections and a short interval between pregnancies.