R. Geeta Vandana1, M. Swarnalatha2, J. Sudha3
BACKGROUND & PURPOSE OF STUDY: The present study is a prospective study to evaluate the usefulness of ultrasonographic measurement of the thickness of the lower uterine segment of post caesarean pregnancy at term for predicting the risk of intrapartum dehiscence.
METHODS: This study was conducted in the Department of OBGYN, King George Hospital, Andhra Medical College, Visakhapatnam, from March 2011 to August 2012. All the pregnant women with previous one cesarean section attending Ante Natal Clinic for confinement were included in the study after giving consent.
RESULTS: The out of 100 cases of post caesarean pregnancy, 42 elective LSCS were done in 14 cases, and VBAC in 17 cases. Out of 58 emergency LSCS repeat elective LSCS were done in 26 cases and 5 cases underwent VBAC. There was no case of perinatal mortality or rupture in the present study.
CONCLUSION: There was significant thinning of lower uterine segment in emergency caesarean group. The 3.5mm mean of LUS thickness was taken as cut off value. There is 46% chance of uterine dehiscence when thickness is <3.5mm. There is 2.3% chance of uterine dehiscence when thickness is >3.5mm. If the thickness of lower uterine segment is >3.5mm the possibility of dehiscence during subsequent trials of labor is very small. Hence transvaginal delivery can be undertaken with more confidence.