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Article: Sonographic measurement of the lower uterine segment thickness in women with previous caesarean section.

TitleSonographic measurement of the lower uterine segment thickness in women with previous caesarean section.
Authors
Issue Date2005
PublisherCanadian Medical Association. The Journal's web site is located at http://sogc.medical.org/JOGC/index_e.shtml
Citation
Journal Of Obstetrics And Gynaecology Canada : Jogc = Journal D'obstetrique Et Gynecologie Du Canada : Jogc, 2005, v. 27 n. 7, p. 674-681 How to Cite?
AbstractOBJECTIVES: To evaluate the accuracy of prenatal sonography in determining the lower uterine segment (LUS) thickness in women with previous Caesarean section and to assess the usefulness of measuring LUS thickness in predicting the risk of uterine rupture during a trial of vaginal birth. METHODS: Sonographic examination was performed in 102 pregnant women with one or more previous Caesarean sections at between 36 and 38 weeks' gestation to assess the LUS thickness, which was defined as the shortest distance between the urinary bladder wall-myometrium interface and the myometrium/chorioamniotic membrane-amniotic fluid interface. Of the 102 women examined, 91 (89.2%) had transabdominal sonography only, and 11 (10.8%) had both transabdominal and transvaginal examinations. The sonographic measurements were correlated with the delivery outcome and the intraoperative LUS appearance. RESULTS: The mean sonographic LUS thickness was 1.8 mm, standard deviation (SD) 1.1 mm. An intraoperatively diagnosed paper-thin or dehisced LUS, when compared with an LUS of normal thickness, had a significantly smaller sonographic LUS measurement (0.9 mm, SD 0.5 mm, vs. 2.0 mm, SD 0.8 mm, respectively; P < 0.0001). Two women had uterine dehiscence, both of whom had prenatal LUS thickness of < 1 mm. Thirty-two women (31.4%) had a successful vaginal delivery, with a mean LUS thickness of 1.9 mm, SD 1.5 mm; none had clinical uterine rupture. A sonographic LUS thickness of 1.5 mm had a sensitivity of 88.9%, a specificity of 59.5%, a positive predictive value of 32.0%, and a negative predictive value of 96.2% in predicting a paper-thin or dehisced LUS. CONCLUSIONS: Sonography permits accurate assessment of the LUS thickness in women with previous Caesarean section and therefore can potentially be used to predict the risk of uterine rupture during trial of vaginal birth.
Persistent Identifierhttp://hdl.handle.net/10722/173293
ISSN
2015 SCImago Journal Rankings: 0.788

 

DC FieldValueLanguage
dc.contributor.authorCheung, VYen_US
dc.date.accessioned2012-10-30T06:29:08Z-
dc.date.available2012-10-30T06:29:08Z-
dc.date.issued2005en_US
dc.identifier.citationJournal Of Obstetrics And Gynaecology Canada : Jogc = Journal D'obstetrique Et Gynecologie Du Canada : Jogc, 2005, v. 27 n. 7, p. 674-681en_US
dc.identifier.issn1701-2163en_US
dc.identifier.urihttp://hdl.handle.net/10722/173293-
dc.description.abstractOBJECTIVES: To evaluate the accuracy of prenatal sonography in determining the lower uterine segment (LUS) thickness in women with previous Caesarean section and to assess the usefulness of measuring LUS thickness in predicting the risk of uterine rupture during a trial of vaginal birth. METHODS: Sonographic examination was performed in 102 pregnant women with one or more previous Caesarean sections at between 36 and 38 weeks' gestation to assess the LUS thickness, which was defined as the shortest distance between the urinary bladder wall-myometrium interface and the myometrium/chorioamniotic membrane-amniotic fluid interface. Of the 102 women examined, 91 (89.2%) had transabdominal sonography only, and 11 (10.8%) had both transabdominal and transvaginal examinations. The sonographic measurements were correlated with the delivery outcome and the intraoperative LUS appearance. RESULTS: The mean sonographic LUS thickness was 1.8 mm, standard deviation (SD) 1.1 mm. An intraoperatively diagnosed paper-thin or dehisced LUS, when compared with an LUS of normal thickness, had a significantly smaller sonographic LUS measurement (0.9 mm, SD 0.5 mm, vs. 2.0 mm, SD 0.8 mm, respectively; P < 0.0001). Two women had uterine dehiscence, both of whom had prenatal LUS thickness of < 1 mm. Thirty-two women (31.4%) had a successful vaginal delivery, with a mean LUS thickness of 1.9 mm, SD 1.5 mm; none had clinical uterine rupture. A sonographic LUS thickness of 1.5 mm had a sensitivity of 88.9%, a specificity of 59.5%, a positive predictive value of 32.0%, and a negative predictive value of 96.2% in predicting a paper-thin or dehisced LUS. CONCLUSIONS: Sonography permits accurate assessment of the LUS thickness in women with previous Caesarean section and therefore can potentially be used to predict the risk of uterine rupture during trial of vaginal birth.en_US
dc.languageengen_US
dc.publisherCanadian Medical Association. The Journal's web site is located at http://sogc.medical.org/JOGC/index_e.shtmlen_US
dc.relation.ispartofJournal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGCen_US
dc.subject.meshAdulten_US
dc.subject.meshCesarean Sectionen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMyometrium - Ultrasonographyen_US
dc.subject.meshPregnancyen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshUltrasonography, Prenatalen_US
dc.subject.meshUterine Rupture - Epidemiology - Prevention & Controlen_US
dc.subject.meshUterus - Ultrasonographyen_US
dc.subject.meshVaginal Birth After Cesareanen_US
dc.titleSonographic measurement of the lower uterine segment thickness in women with previous caesarean section.en_US
dc.typeArticleen_US
dc.identifier.emailCheung, VY:vytc@hku.hken_US
dc.identifier.authorityCheung, VY=rp01323en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid16100622-
dc.identifier.scopuseid_2-s2.0-26944465779en_US
dc.identifier.volume27en_US
dc.identifier.issue7en_US
dc.identifier.spage674en_US
dc.identifier.epage681en_US
dc.publisher.placeCanadaen_US
dc.identifier.scopusauthoridCheung, VY=7005439023en_US

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