Preoperative diagnosis of dehiscence of the lower uterine segment in patients with a single previous Caesarean section.
Preoperative diagnoses were checked during surgery in 39 patients who underwent elective repeat Caesarean section with (n = 20) and without (as control, n = 19) a preoperative diagnosis of wall dehiscence (thinning) of the lower uterine segment (LUS). All patients were examined manually and by ultrasonography at 36 weeks gestation before labour. A preoperative diagnosis of wall dehiscence was made when the wall thickness was less than 2 mm and/or the patient felt pain and tenderness in the LUS. Surgical findings of dehiscence were defined as a subperitoneal separation of the uterine scar in the LUS. The sensitivity and specificity of our ultrasonographic evaluations were found to be 100% and 83% (p < 0.05), respectively. On the other hand, there were no surgical findings of dehiscence in patients who felt pain and tenderness in the LUS with a wall thickness greater than 2 mm, nor among those in the control group.
Suzuki
S
S
Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan.
Sawa
R
R
Yoneyama
Y
Y
Asakura
H
H
Araki
T
T
D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D010146:Pain / Q000209:etiology; D018579:Patient Selection; D010808:Physical Examination / Q000592:standards*; D011247:Pregnancy; D011300:Preoperative Care / Q000379:methods*; D012086:Reoperation; D012680:Sensitivity and Specificity; D013529:Surgical Wound Dehiscence / Q000150:complications / Q000175:diagnosis*; D016216:Ultrasonography, Prenatal / Q000592:standards*; D016064:Vaginal Birth after Cesarean