Background: With the increasing global rates of primary cesarean sections, there has been a corresponding rise in the occurrence of repeat cesarean sections. An antenatal ultrasonographic assessment of the lower uterine segment could contribute to the safety of women who are considering a trial of labor by identifying those with a lower risk of uterine rupture. This research aims to investigate the relationship between ultrasonographic scar thickness and the intraoperative condition of the uterine scar, as well as the outcomes for both the mother and the fetus in cases where the patient has previously undergone a lower segment cesarean section (LSCS).
Materials and Methods: Patients of previous caesarian section cases as per inclusion criteria attending to Navodaya Medical College Hospital and Research Centre, Raichur during the study period of 2021-2023 were included in the present study. Patients found to have scar thickness ?2.5 mm and fulfilling the above mentioned criteria were allowed a trial of labor. Patients with a scar thickness < 2>
Results: In the present study, it was observed that the majority of patients, 49 (49.0%), belonged to the age group of 25-29 years, followed by 33 (33.0%) in the 20-24 age group, and 14 (14.0%) in the 30-34 age group. Furthermore, the majority of patients, 76 (76.0%), were second gravida. Most patients, 85 (85.0%), were of primi gravida, and again, there was no statistically significant difference in parity found between groups (P>0.05).
The high-risk group experienced a shorter gestational period in comparison to the low-risk group. Notably, 32% of patients in the low-risk group had an inter-delivery interval of 2.5 to 3.5 years, while 60% of patients in the high-risk group had an inter-delivery interval of 1.5 to 2.5 years. NICU admission, required by 3% of newborns, reflects a broader spectrum of health issues that necessitate specialized care beyond standard postnatal care.
Conclusion: Ultrasonographic assessment of LUS is an excellent, non-invasive and cost effective method for safely predicting scar integrity and can be recommended to be routinely incorporated in antenatal workup of a woman with previous caesarean section for deciding on the mode of delivery.
Keywords: Scar thickness, Intraoperative uterine scar, Feto-maternal outcome, Previous LSCS.
