Beta
26688

The Use of Trans Abdominal Ultrasound in Assessment of the Lower Uterine Segment Thickness in Patients with Previous Cesarean Section

Article

Last updated: 24 Dec 2024

Subjects

-

Tags

-

Abstract

Introduction: There is a steady increase in the rate of cesarean delivery. In Egypt, Cesarean sections were performed in 38.84% of deliveries in 2008, 37.88% in 2009, 39.08% in 2010, 37.72% in 2011 and 41.17% in 2012, repeated cesarean sections (RCS) was the main indication. In making plans for delivery, physicians and patients should consider a woman's chance of a successful VBAC as well as the risk of complications from a trial of labor. Approximately 60-80% of appropriate candidates who attempt vaginal birth after cesarean (VBAC) will be successful. Aim of the Work: was to determine a cut-off value that can be clinically used to allow a safe vaginal delivery by using abdominal ultrasound to evaluate the thickness of the lower uterine segment in patients with history of previous cesarean section. Patients and Methods: The lower uterine segment thickness was measured by both transabdominal ultrasound in 200 cases, gravidas (37 week – 40 week),100 cases with previous CS (study group) undergoing repeated CS, and the other 100 cases without any scar in the uterus (control group), then the grade of the scar was assessed intraoperatively. Results: By TAS the best cut- off value was 2.5 mm and this yielded a sensitivity of 77.3% and a specificity of 73.5%. At this cut-off value, the positive predictive value was 85% while the negative predictive was 62.5% and the accuracy was 76%. Conclusion: Ultrasonographic evaluation permits good assessment of the risk of scar complications intra partum. The lower uterine segment thickness is related to the grade of the scar. The best timing to perform the scan is at late third trimester. A cut-off value of 2.5 mm by TAS can be safely used with high degree of sensitivity and specificity.

DOI

10.21608/ejhm.2019.26688

Keywords

Ultrasound, Lower uterine segment, previous cesarean section, VBAC

Authors

First Name

Ismael M.

Last Name

Mira

MiddleName

-

Affiliation

Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University,Cairo, Egypt

Email

-

City

-

Orcid

-

First Name

Abdel-Monsef A.

Last Name

Sedek

MiddleName

-

Affiliation

Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University,Cairo, Egypt

Email

-

City

-

Orcid

-

First Name

Ahmed T.

Last Name

Ahmed

MiddleName

-

Affiliation

Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University,Cairo, Egypt

Email

kingohamada@gmail.com

City

-

Orcid

-

Volume

74

Article Issue

6

Related Issue

4763

Issue Date

2019-01-01

Receive Date

2019-02-08

Publish Date

2019-01-01

Page Start

1,306

Page End

1,313

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_26688.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=26688

Order

13

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

The Use of Trans Abdominal Ultrasound in Assessment of the Lower Uterine Segment Thickness in Patients with Previous Cesarean Section

Details

Type

Article

Created At

22 Jan 2023