THE PREDICTIVE VALUE OF ULTRASONOGRAPHIC ASSESSMENT OF LOWER SEGMENT SCAR INTEGRITY IN PATIENT WITH PREVIOUS CAESAREAN SECTION NEAR TERM.

Abstract

to determine the predictive value of trans-abdominal (TA) US in assessing thickness of lower uterine segment by measuring lower uterine segment (LUS) scar thickness at term in patient with previous CS. Patient and methods: This study was carried out as tool- assessment cross-sectional case study on pregnant females, who had previous cesarean section at 36-40W of gestation and planning for elective CS. LUS thickness measured by TAUS and measured by the surgeon after labour using a sterile vernier caliper. The sensitivity, specificity, positive and negative predicted values of the TAUS measurement was determined. Results: eighty nine women were studied at a mean gestational age of 38.5±0.59weeks. With cut-off value equal to or less than 2.4 mm , the sensitivity, specificity, positive and negative predicted values were 90%, 100%, 100%, and 98.7%, respectively. Conclusion: LUS measurement is a useful clinical tool in the prediction of scar integrity. It should be performed routinely in women who had a previous cesarean before labour. Key word: cesarean section(CS), lower uterine segment (LUS), trans-abdominal ultrasound (TAUS). scar thickness