Correlation of Gravidity with Cesarean Section Scar Thickness on Ultrasound in Third Trimester of Pregnancy
Article Sidebar
Main Article Content
Abstract
Background: The correlation between gravidity and cesarean scar thickness is an important consideration in obstetric care, particularly in the context of predicting complications in subsequent pregnancies following a cesarean delivery. Previous studies have provided varied insights, but the relationship remains incompletely understood.
Objective: This study aimed to determine the correlation between gravidity and cesarean section scar thickness as assessed by ultrasound in the third trimester of pregnancy.
Methods: A cross-sectional analytical study was conducted with 100 females from the community, recruited from the University of Lahore Teaching Hospital, Lahore. The study focused on assessing cesarean scar thickness in relation to gravidity. Participants’ age ranged from 18 to 44 years. Data were analyzed using statistical methods to determine the correlation between independent variables (age, trimester) and the dependent variable (cesarean section scar thickness).
Results: The mean scar thickness measured by transabdominal ultrasound from 36 to 38 weeks was 3.05 mm. The p-value for the correlation between gravidity and cesarean scar thickness was -0.141, indicating no significant correlation. Additionally, the study found no substantial evidence to suggest that gravidity is a reliable predictor of cesarean scar thickness.
Conclusion: The study concludes that gravidity does not significantly correlate with cesarean scar thickness in the third trimester. This finding underscores the necessity for a more individualized approach in assessing risks associated with VBAC and other pregnancy-related complications in women with a history of cesarean deliveries.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Shwetha S, Ramaiah R, Aparna: Assessment of lower segment scar integrity by ultrasound in near term pregnant women with previous caesarean section: A study. Eur J Mol Clin Med. 2022, 9:1093-1102. www.thefreelibrary.com/Assessment+of+Lower+Segment+Scar+Integrity+by+Ultrasound+in+Near+Term...-a0765922645 2. Weckesser A, Farmer N, Dam R, Wilson A, Morton VH, Morris RK: Women’s perspectives on caesarean section recovery, infection, and the PREPS trial: a qualitative pilot study. BMC Pregnancy Childbirth. 2019, 19:1-10. 10.1186/s12884-019-2402-8 3. Basic E, Basic-Cetkovic V, Kozaric H, Rama A: Ultrasound evaluation of uterine scar after cesarean section. Acta Inform Med. 2012, 20:149-53. 10.5455/aim.2012.20.149-153
National Institutes of Health Consensus Development conference statement: vaginal birth after cesarean: new insights March 8-10, 2010. Obstet Gynecol. 2010, 115:1279-1295. 10.1097/AOG.0b013e3181e459e5 5. Nkhata G: Factors associated with failed vaginal delivery in women with one previous caesarean section at the university teaching hospital, The University of Zambia Lusaka, Zambia;2019. http://library.adhl.africa/handle/123456789/14172 6. Pallasmaa N: Cesarean section-short term maternal complications related to the mode of delivery . Medica-odontologica, Annales Universitatis Turkuensis. Turku; 2014. http://www.utupub.fi/bitstream/handle/10024/96742/AnnalesD1119Pallasmaa.pdf?sequence=2&isAllowed=y 7. Deng MF, Zhang XD, Zhang QF, Liu J: Uterine rupture in patients with a history of multiple curettages: Two case reports. World J Clin Cases. 2020, 8:6322-6329. 10.12998/wjcc.v8.i24.6322
Committee on Obstetric Practice: Committee opinion no. 529: placenta accreta . Obstet Gynecol. 2012, 120:207-11. 10.1097/AOG.0b013e318262e340 9. El-Ewiny, I., Kassab, F., Abdul-Jaleel, K: The role of ultrasound versus hysteroscopy in assessment of cesarean section scar in non pregnant females. The. Egyp J Hosp Med. 2019, 74:775-781. 10.21608/ejhm.2019.24171 10. Guise JM, Eden K, Emeis C, et al.: Vaginal birth after cesarean: new insights . Evid Rep Technol Assess. 2010, 191:1-397. http://pubmed.ncbi.nlm.nih.gov/20629481/ 11. Kok N, Wiersma IC, Opmeer BC, de Graaf IM, Mol BW, Pajkrt E: Sonographic measurement of lower uterine segment thickness to predict uterine rupture during a trial of labor in women with previous Cesarean section: a meta-analysis. Ultras Obstet Gynecol. 2013, 42:132-9. 10.1002/uog.12479 12. Jastrow N, Gauthier RJ, Gagnon G, Leroux N, Beaudoin F, Bujold E: Impact of labor at prior cesarean on lower uterine segment thickness in subsequent pregnancy. Am J Obstet Gynecol. 2010, 202:563-1. 10.1016/j.ajog.2009.10.894 13. Bujold E, Jastrow N, Simoneau J, Brunet S, Gauthier RJ: Prediction of complete uterine rupture by sonographic evaluation of the lower uterine segment. Am J Obstet Gynecol. 2009, 201:320-1. 10.1016/j.ajog.2009.06.014 14. Abosrie M, Farag MA: Prediction of cesarean section scar dehiscence before delivery using three-dimensional transabdominal ultrasonography. Benha Med J. 2015, 32:101. 10.4103/1110-208X.180322
Laflamme SM, Jastrow N, Girard M, Paris G, Bérubé L, Bujold E: Pitfall in ultrasound evaluation of uterine scar from prior preterm cesarean section. AJP Rep. 2011, 1:65-8. 10.1055/s-0031-1284222 16. Paquette K, Markey S, Roberge S, Girard M, Bujold E, Demers S: First and third trimester uterine scar thickness in women with previous caesarean: a prospective comparative study. J Obstet Gynaecol Can. 2019, 41:59-63. 10.1016/j.jogc.2018.02.020 17. Vikhareva Osser O, Valentin L: Clinical importance of appearance of cesarean hysterotomy scar at transvaginal ultrasonography in nonpregnant women. Obstet Gynecol. 2011, 117:525-532. 10.1097/AOG.0b013e318209abf0 18. Ramteke S,Wankhede S: Scar thickness as a variable for deciding the mode of delivery in patients with previous one caesarean section: a prospective observational study. J Den Med Sci. 2020, 19:21-25. 10.9790/0853-1904052125 19. Rao J, Fan D, Chen T, et al.: Changes in lower uterine segment thickness during different gestational weeks in pregnant women qualified for trial of labor after cesarean section. Int J Gynaecol Obstet. 2022, 157:710-718. 10.1002/ijgo.13902 20. Fukuda M, Fukuda K, Shimizu T, Bujold E: Ultrasound assessment of lower uterine segment thickness during pregnancy, labour and the postpartum period. J Obstet Gynaecol Can. 2016, 38:134-40. 10.1016/j.jogc.2015.12.009 21. Ram M, Hiersch L, Ashwal E, et al.: Trial of labor following one previous cesarean delivery: the effect of gestational age. Arch Gynecol Obstet. 2018, 297:907-913. 10.1007/s00404-018-4677-9 22. Chandi A, Sirohiwal D, Yadav S: Trial of labor in patients with previous caesarean delivery and significance of scar thickness and inter-caesarean interval. BAOJ. 2016, 1:004. 10.24947/baojgn/1/1/00104 23. Baron J, Weintraub AY, Eshkoli T, Hershkovitz R, Sheiner E: The consequences of previous uterine scar dehiscence and cesarean delivery on subsequent births. Int J Gynaecol Obstet. 2014, 126:120-2. 10.1016/j.ijgo.2014.02.022 24. Jastrow N, Roberge S, Gauthier RJ, et al.: Effect of birth weight on adverse obstetric outcomes in vaginal birth after cesarean delivery. Obstet Gynecol. 2010, 115:338-343. 10.1097/AOG.0b013e3181c915da
Tyagi N, Prabhakar M, Tyagi S: Retrospective study to find predictive factors of scar dehiscence in previous caesarean section to prevent maternal and perinatal morbidity and mortality. Int J Reprod Contracept Obstet Gynecol. 2019, 8:531-536. 10.18203/2320-1770.ijrcog20190279 26. Landon MB: Predicting uterine rupture in women undergoing trial of labor after prior cesarean delivery. Semin Perinatol. 2010, 34:267-271. 10.1053/j.semperi.2010.03.005 27. Wu Y, Kataria Y, Wang Z, Ming WK, Ellervik C: Factors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2019, 19:360.10.1186/s12884-019-2517-y 28. Swift BE, Shah PS, Farine D: Sonographic lower uterine segment thickness after prior cesarean section to predict uterine rupture: a systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2019, 98:830-841. 10.1111/aogs.13585 29. Gad MS, Abd El Sttar MM, Abd El Gayed AM, Mahmoud NF: Evaluation of lower segment cesarean section scar by sonography. Menoufia Med J. 2015, 28:873-8. 10.4103/1110-2098.173606 30. Kalyankar B, Kalyankar V, Gadappa S, Gaikwad KA: Correlation of maternal and early neonatal outcome with strength of lower segment caesarean section scar on abdominal ultrasonography. The New. New Indian J Obstet Gynecol. 2021, 7:142-47. 10.21276/obgyn.2021.7.2.6