ABSTRACT
Objective: to access of the efficacy of
three dimensional ultrasound (3DUS)
in prediction of cesarean scar dehiscence in pregnant patients at term and
comparing the outcome of measurement to the intraoperative visual assessment of the scar.
Design: prospective study.
Participants & Methods: 70 pregnant
women with a history of prior cesarean section attending benha University
hospital. All participants underwent a
3D transabdominal scan at third trimester and the data was recorded. We
measured the lower segment thickness
from the muscularis and mucosa of
the bladder on the outer side to the
chorioamniotic membrane on the inner side, with the myometrium in between and hence, depending on a 3-
layered pattern. This was compared
with the pregnancy outcome and the
intraoperative scar condition. The
data was then statistically analyzed.
Results: The mean scar thickness as
measured by 3D transabdominal sonography in the third trimester
was4.63±0.85 mm. the best cut-off level for predicting uterine scar defects
was. ≤2.5 mm (highest diagnostic accuracy) with sensitivity 25%, specificity
100%, PPV 100% & NPV 95%.
Conclusions: The current study suggests that prenatal 3D US examination
determining the degree of LUS thinning in patients with previous caesarean delivery which is considered better
negative screening test than positive
due to higher specificity than sensitivity.3D Ultrasound provides an additional element for assessing the risk of
uterine rupture and may increase safe
management of trial of labour |
