Publication:

Study of obstetric and perinatal outcome in previous cesarean by sonographic evaluation of scar thickness of lower uterine segment at term

Background Aim of study was to evaluate sonographically the scar thickness in pregnant women with previous one cesarean and study obstetric and perinatal outcome after trial of labour based on scar thickness.

Methods 50 pregnant women of gestational age >37 weeks were included in this prospective study. They were subjected to transabdominal ultrasound to search for thinnest zone of lower segment. Cases with scar thickness <3.5 mm were subjected to elective caesarean LSCS. Cases with scar thickness ≥3.5 were subjected to a trial of labour. Obstetric, perinatal outcome and hospital stay was studied.

Results 32 women had scar thickness ≥3.5 mm (mean = 3.99 ± 0.32). 18 women had scar thickness of <3.5 mm (mean = 3.16 ± 0.29). All patients subjected to elective LSCS showed Grade 2 and Grade 3 thinning of lower segment. This finding was found to be highly significant (p<0.001). Cases who delivered vaginally had hospital stay ranging from 30 hours to 70 hours while those undergoing LSCS stayed 230 to 280 hours. This difference was statistically highly significant (p<0.001). The perinatal outcome was good.

Conclusions Sonographic evaluation of scar thickness is safe and accurate procedure and is recommended in considering a trial of labour after previous one caesarean.