Objective: to access of the efficacy of three dimensional ultrasound (3DUS) in prediction of cesarean scar dehis-cence in pregnant patients at term and comparing the outcome of measure-ment to the intraoperative visual as-sessment of the scar.
Design: prospective study.
Participants & Methods: 70 pregnant women with a history of prior cesare-an section attending benha University hospital. All participants underwent a 3D transabdominal scan at third tri-mester 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 in-ner side, with the myometrium in be-tween 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 so-nography in the third trimester was4.63±0.85 mm. the best cut-off lev-el for predicting uterine scar defects was. ≤2.5 mm (highest diagnostic accu-racy) with sensitivity 25%, specificity 100%, PPV 100% & NPV 95%.
Conclusions: The current study sug-gests that prenatal 3D US examination determining the degree of LUS thin-ning in patients with previous caesare-an delivery which is considered better negative screening test than positive due to higher specificity than sensitivi-ty.3D Ultrasound provides an addi-tional element for assessing the risk of uterine rupture and may increase safe management of trial of labour |
