title: Sonographic assessment of lower uterine segment thickness at term in women with previous cesarean delivery.
abstract: OBJECTIVE
  The purpose of this study was to establish the validity of abdominal sonographic evaluation of lower uterine segment (LUS) thickness in full-term pregnancies with a single previous cesarean section, and to assess the usefulness of measuring LUS thickness in predicting the risk of uterine dehiscence.
  
  
  METHODS
  Three hundred and thirty-six women with a single previous cesarean section who had an ultrasound measurement of the LUS thickness in pregnancy were enrolled. Abdominal sonographic assessment of LUS was carried out within 2 weeks of delivery. Sonographic measurements were correlated visual finding of a uterine scar at the time of the iterative cesarean section. Receiver operating curve analyses has been used to determine the detection rate and the risk of each actual value of LUS thickness vs. a thin uterine scar.
  
  
  RESULTS
  In our present study, 2.5 mm was considered the critical cut-off value of the LUS thickness. This critical cut-off value was derived from the ROC curve with sensitivity, specificity, PPV, and NPV of 90.9, 84, 71.4, and 95.5 %, respectively (using transabdominal ultrasound). The linear regression model analysis revealed that full LUS thickness of <2.5 mm was the only factor to be correlated with translucent lower uterine segment (C3) (8.8 vs. 0 %; P = 0.02).
  
  
  CONCLUSIONS
  Full LUS thickness of <2.5 mm is associated with a higher risk of uterine dehiscence.
authors: Gynekologické centrum Nitra s.r.o, Nitra, Slovakia, uharcek@gmx.net.
authors: Peter
authors: P
authors: Uharček
authors: Alexander
authors: A
authors: Brešťanský
authors: Jozef
authors: J
authors: Ravinger
authors: Andrea
authors: A
authors: Máňová
authors: Mária
authors: M
authors: Zajacová
mesh_terms: D000328:Adult; D002585:Cesarean Section; D002921:Cicatrix / Q000150:complications*; D005260:Female; D006801:Humans; D016014:Linear Models; D011247:Pregnancy; D012372:ROC Curve; D012680:Sensitivity and Specificity; D047929:Term Birth; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014597:Uterine Rupture / Q000000981:diagnostic imaging*; D014599:Uterus / Q000000981:diagnostic imaging*; D016064:Vaginal Birth after Cesarean