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- Scopus: eid_2-s2.0-26944465779
- PMID: 16100622
- WOS: WOS:000442830900005
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Article: Sonographic measurement of the lower uterine segment thickness in women with previous caesarean section.
Title | Sonographic measurement of the lower uterine segment thickness in women with previous caesarean section. |
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Authors | |
Keywords | Caesarean section Lower uterine segment thickness Sonography Ultrasound Uterine rupture Vaginal birth after Caesarean section |
Issue Date | 2005 |
Publisher | Canadian 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? |
Abstract | OBJECTIVES: 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 Identifier | http://hdl.handle.net/10722/173293 |
ISSN | 2023 Impact Factor: 2.0 2023 SCImago Journal Rankings: 0.611 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Cheung, VY | en_US |
dc.date.accessioned | 2012-10-30T06:29:08Z | - |
dc.date.available | 2012-10-30T06:29:08Z | - |
dc.date.issued | 2005 | en_US |
dc.identifier.citation | Journal Of Obstetrics And Gynaecology Canada : Jogc = Journal D'obstetrique Et Gynecologie Du Canada : Jogc, 2005, v. 27 n. 7, p. 674-681 | en_US |
dc.identifier.issn | 1701-2163 | en_US |
dc.identifier.uri | http://hdl.handle.net/10722/173293 | - |
dc.description.abstract | OBJECTIVES: 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.language | eng | en_US |
dc.publisher | Canadian Medical Association. The Journal's web site is located at http://sogc.medical.org/JOGC/index_e.shtml | en_US |
dc.relation.ispartof | Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC | en_US |
dc.subject | Caesarean section | - |
dc.subject | Lower uterine segment thickness | - |
dc.subject | Sonography | - |
dc.subject | Ultrasound | - |
dc.subject | Uterine rupture | - |
dc.subject | Vaginal birth after Caesarean section | - |
dc.subject.mesh | Adult | en_US |
dc.subject.mesh | Cesarean Section | en_US |
dc.subject.mesh | Female | en_US |
dc.subject.mesh | Humans | en_US |
dc.subject.mesh | Myometrium - Ultrasonography | en_US |
dc.subject.mesh | Pregnancy | en_US |
dc.subject.mesh | Risk Factors | en_US |
dc.subject.mesh | Ultrasonography, Prenatal | en_US |
dc.subject.mesh | Uterine Rupture - Epidemiology - Prevention & Control | en_US |
dc.subject.mesh | Uterus - Ultrasonography | en_US |
dc.subject.mesh | Vaginal Birth After Cesarean | en_US |
dc.title | Sonographic measurement of the lower uterine segment thickness in women with previous caesarean section. | en_US |
dc.type | Article | en_US |
dc.identifier.email | Cheung, VY:vytc@hku.hk | en_US |
dc.identifier.authority | Cheung, VY=rp01323 | en_US |
dc.description.nature | link_to_subscribed_fulltext | en_US |
dc.identifier.pmid | 16100622 | - |
dc.identifier.scopus | eid_2-s2.0-26944465779 | en_US |
dc.identifier.volume | 27 | en_US |
dc.identifier.issue | 7 | en_US |
dc.identifier.spage | 674 | en_US |
dc.identifier.epage | 681 | en_US |
dc.identifier.isi | WOS:000442830900005 | - |
dc.publisher.place | Canada | en_US |
dc.identifier.scopusauthorid | Cheung, VY=7005439023 | en_US |
dc.identifier.issnl | 1701-2163 | - |