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Evaluation of lower uterine segment thickness in pregnant women with previous cesarean section and pain at term
Mustafa Göksu1, Pınar Kadiroğulları2, Kerem Doğa Seçkin3, Büşra Şahin4, Yusuf Başkıran51Department of Obstetrics and Gynecology, Istanbul Health Sciences University, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey2Department of Obstetrics and Gynecology, Acibadem University Atakent Hospital, Istanbul, Turkey
3Department of Obstetrics and Gynecology, Istinye University Liv Hospital Vadi Istanbul, Istanbul, Turkey
4Department of Obstetrics and Gynecology, Ordu University Training and Research Hospital, Ordu, Turkey
5Department of Obstetrics and Gynecology, Istinye University Liv Hospital Bahcesehir, Istanbul, Turkey
INTRODUCTION: The aim of this study was to evaluate the thickness of the lower uterine segment (LUS) by ultrasonography in patients with and without pain who had a previous cesarean section and to determine a cut-off thickness value that can predict uterine rupture by comparing the values found.
METHODS: A total of 100 pregnant women with previous cesarean section who presented to the emergency department with pain and 100 pregnant women without pain who were scheduled for elective cesarean section were evaluated. In both groups, endometrial wall thickness was measured by ultrasonography at presentation. Intraoperative findings were recorded according to the Qureshi scoring system.
RESULTS: An LUS thickness of 1.75 mm was considered the critical cut-off value, obtained from the ROC curve with 90% sensitivity and 90% specificity using transabdominal ultrasonography. Linear regression model analysis revealed that a full LUS thickness <1.75 mm was the only factor associated with a translucent uterine segment (C3).
DISCUSSION AND CONCLUSION: We found an increased risk of uterine rupture at an ultrasonographic thickness <1.75 mm in pregnant women with pain and previous cesarean section. Ultrasonographic niche measurement will enable appropriate obstetric care to prevent adverse maternal and fetal outcomes and will alert physicians for a planned cesarean section.
Manuscript Language: English
