OPERATIVE AND ULTRA-SONOLOGICAL ASSESSMENT OF LOWER UTERINE SEGMENT THICKNESS IN PREDICTING SCAR DEHISCENCE

Background: As caesarean section rates are increasing so a valid, non-invasive and reliable method to assess integrity of caesarean scar is required to select patients for safe trial of labour. The objective of this study was to determine accuracy of ultrasound-based lower uterine segment thickness assessment in predicting risk of scar dehiscence in women with previous one lower uterine caesarean scar. Materials & Methods: The study design was descriptive longitudinal conducted in Gynae and Obstetrics Department, PIMS Hospital, Islamabad for the duration of 6 months. Sample size was 93 and sampling technique was consecutive non probability. Our sociodemographic variables were age and parity. Our research variables were thickness of lower uterine segment on ultrasonography and scar thickness intraoperatively. Data was stratified for age and parity and validity of ultrasound findings was evaluated taking intra-operative scar assessment as gold standard. All variables were described descriptively as frequency and percentages for each stratum. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of USG assessment was calculated. Results: The sensitivity, specificity, PPV, NPV and diagnostic accuracy of ultrasonographic findings was 89.36%, 91.3%, 91.3%, 89.36%, 90.32% respectively taking intra-operative scar assessment as gold standard. Conclusion: The measurement of lower uterine segment thickness by transabdominal ultrasound agrees strongly with intra-operative assessment having high diagnostic accuracy.