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Article: Sonographic evaluation of the lower uterine segment in patients with previous cesarean delivery

TitleSonographic evaluation of the lower uterine segment in patients with previous cesarean delivery
Authors
Issue Date2004
PublisherAmerican Institute for Ultrasound in Medicine. The Journal's web site is located at http://www.aium.org/publications/jum/subIndv.asp
Citation
Journal Of Ultrasound In Medicine, 2004, v. 23 n. 11, p. 1441-1447 How to Cite?
AbstractObjective. To evaluate the appearance of the lower uterine segment (LUS) in pregnant women with previous cesarean delivery and to compare the LUS thickness with that in women with unscarred uteri. Methods. In a prospective study, sonographic examination was performed on 53 pregnant women with previous cesarean delivery (cesarean group), 40 nulliparas (nullip-control), and 40 women who had 1 or more childbirths with unscarred uteri (multip-control) between 36 and 38 weeks' gestation to assess the appearance and compare the thickness of the LUS. In the cesarean group, the sonographic findings were correlated with the delivery outcome and the intraoperative LUS appearance. Results. In the cesarean group, 44 patients (83.0%) had a normal-appearing LUS indistinguishable from that of control groups; 2 patients (3.8%) had an LUS defect suggestive of dehiscence; and 7 patients (13.2%) had thickened areas of increased echogenicity with or without myometrial thinning. Although the cesarean group had a thinner LUS (1.9 ± 1.4 mm) when compared with both the nullip-control group (2.3 ± 1.1 mm; P > .05) and the multip-control group (3.4 ± 2.2 mm; P < .001), only the latter difference achieved statistical significance. One of the 2 patients who had a sonographically suspected LUS defect had confirmed uterine dehiscence during surgery. An intraoperatively diagnosed paper-thin LUS, when compared with an LUS of normal thickness, had significantly smaller sonographic LUS measurements (1.1 ± 0.6 versus 2.0 ± 0.8 mm, respectively; P = .004). Conclusions. Prior cesarean delivery is associated with a sonographically thinner LUS when compared with those with prior vaginal delivery. Prenatal sonographic examination is potentially capable of diagnosing a uterine defect and determining the degree of LUS thinning in patients with previous cesarean delivery.
Persistent Identifierhttp://hdl.handle.net/10722/173349
ISSN
2015 Impact Factor: 1.544
2015 SCImago Journal Rankings: 0.645
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCheung, VYTen_US
dc.contributor.authorConstantinescu, OCen_US
dc.contributor.authorAhluwalia, BSen_US
dc.date.accessioned2012-10-30T06:29:32Z-
dc.date.available2012-10-30T06:29:32Z-
dc.date.issued2004en_US
dc.identifier.citationJournal Of Ultrasound In Medicine, 2004, v. 23 n. 11, p. 1441-1447en_US
dc.identifier.issn0278-4297en_US
dc.identifier.urihttp://hdl.handle.net/10722/173349-
dc.description.abstractObjective. To evaluate the appearance of the lower uterine segment (LUS) in pregnant women with previous cesarean delivery and to compare the LUS thickness with that in women with unscarred uteri. Methods. In a prospective study, sonographic examination was performed on 53 pregnant women with previous cesarean delivery (cesarean group), 40 nulliparas (nullip-control), and 40 women who had 1 or more childbirths with unscarred uteri (multip-control) between 36 and 38 weeks' gestation to assess the appearance and compare the thickness of the LUS. In the cesarean group, the sonographic findings were correlated with the delivery outcome and the intraoperative LUS appearance. Results. In the cesarean group, 44 patients (83.0%) had a normal-appearing LUS indistinguishable from that of control groups; 2 patients (3.8%) had an LUS defect suggestive of dehiscence; and 7 patients (13.2%) had thickened areas of increased echogenicity with or without myometrial thinning. Although the cesarean group had a thinner LUS (1.9 ± 1.4 mm) when compared with both the nullip-control group (2.3 ± 1.1 mm; P > .05) and the multip-control group (3.4 ± 2.2 mm; P < .001), only the latter difference achieved statistical significance. One of the 2 patients who had a sonographically suspected LUS defect had confirmed uterine dehiscence during surgery. An intraoperatively diagnosed paper-thin LUS, when compared with an LUS of normal thickness, had significantly smaller sonographic LUS measurements (1.1 ± 0.6 versus 2.0 ± 0.8 mm, respectively; P = .004). Conclusions. Prior cesarean delivery is associated with a sonographically thinner LUS when compared with those with prior vaginal delivery. Prenatal sonographic examination is potentially capable of diagnosing a uterine defect and determining the degree of LUS thinning in patients with previous cesarean delivery.en_US
dc.languageengen_US
dc.publisherAmerican Institute for Ultrasound in Medicine. The Journal's web site is located at http://www.aium.org/publications/jum/subIndv.aspen_US
dc.relation.ispartofJournal of Ultrasound in Medicineen_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.meshProspective Studiesen_US
dc.subject.meshUltrasonography, Prenatalen_US
dc.subject.meshUterus - Ultrasonographyen_US
dc.subject.meshVaginal Birth After Cesareanen_US
dc.titleSonographic evaluation of the lower uterine segment in patients with previous cesarean deliveryen_US
dc.typeArticleen_US
dc.identifier.emailCheung, VYT:vytc@hku.hken_US
dc.identifier.authorityCheung, VYT=rp01323en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid15498908-
dc.identifier.scopuseid_2-s2.0-6944238550en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-6944238550&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume23en_US
dc.identifier.issue11en_US
dc.identifier.spage1441en_US
dc.identifier.epage1447en_US
dc.identifier.isiWOS:000224718900005-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridCheung, VYT=7005439023en_US
dc.identifier.scopusauthoridConstantinescu, OC=7003747253en_US
dc.identifier.scopusauthoridAhluwalia, BS=7004817974en_US

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