Ultrasound Predictability of Lower Uterine Segment Cesarean Section Scar Thickness

Objective: The objective of this study is to find out association between scar thickness, assessed sonographically, and intraoperative findings (IOF). Study Design: Descriptive study. Place and Duration of Study: Department of Gynecology and Obstetrics, Sharif Medical and Dental College, Lahore, from June 2016 to April 2017. Methodology: A total of 70 pregnant patients were included in this study. Transabdominal ultrasound was done for scarred uteri. Sonographic findings were co-related with introperative findings. All the given data were entered on SPSS version 23. Age was expressed as mean +/- SD. Parity, gestational age, and interval between cesarean sections were expressed as frequencies with percentages. Statistical analysis was done by using Chi-square test for categorical data for association between sonographic scar thickness and intraoperative findings. The statistical significance was set at p-value <= 0.05. Results: The age range of the patients was 20-36 years with a mean of 27.91 +/- 3.690 years. Gestational age at the time of cesarean section was between 27-40 weeks of gestation with a mean of 37 +/- 2.126 weeks. The interval from previous cesarean was 10 months at the minimum, and 6 years at the maximum with a mean of 2.29 +/- 1.0 months. Mean scar thickness was 2.5 mm. Association between scar thickness (< 1-3 mm) and intaoperative findings of dehiscence and rupture showed a p-value of < 0.001. Conclusion: Sonographic assessment of a uterine scar has a practical application to determine the thickness of previous scar, and assess its integrity.