First Trimester Uterine Scar Assessment by Transvaginal Ultrasound
Shaymaa Mohammed Sameer AbdelAall;
Abstract
Summary Summary
he number of deliveries by CS has been increasing steadily worldwide in recent decades. Although it is often assumed that CS improves neonatal outcomes, there is no hard scientific evidence to support this.
The safety of CS, however, has increased owing to improvements in surgical and anaesthetic techniques, increased safety of blood transfusion and routine use of antibiotics and thromboprophylaxis.
As a result of this operation late scar dehiscence may occur, which may lead to uterine rupture in a subsequent pregnancy. Uterine rupture is an uncommon but potentially catastrophic.
Studies have shown that the risk of uterine rupture in the presence of a defective scar is directly related to the degree of thinning of the lower uterine segment.
A number of objective methods have been used to evaluate the cesarean scar defects. These include hysteron-salpingogram as anterior out pouching. As non invasive alternative procedures, MRI and CT scan also be diagnostic.
Several studies have compared the thickness of the LUS measured by ultrasound with the thickness assessed during surgery.
T
Summary and Conclusion
99
Although most of the attention has focused on second- and third-trimester diagnosis of abnormal placental insertion and risk of rupture during labor in patients with a history of LSCS. It may be that first-trimester screening could allow early recognition of patients at risk for any of these perinatal complications.
Indeed, the first trimester is increasingly considered as a starting point for stratifying patients at risk of subsequent obstetric complications, such as placenta previa.
The first trimester is possibly the best time to achieve visualization of the scar and its relationship with the trophoblast, which may suggest or rule out abnormal placental insertions.
The aim of the current study was to assess the efficacy of the first trimesteric transvaginal ultrasound in prediction of Cesarean scar dehiscence in women with previous CS comparing to intra operative visual assessment of the scar at term.
In the current study 185 women with history of previous one CS were recruited from the obstetric outpatient clinic of Ain Shams university maternity hospital and Dar Elshefa hospital.
Transvaginal ultrasound was done in the Ultrasound Unit in Ain shams university maternity hospital. Evaluation of CS scar was done, using measurement of the thickness of the remaining myometrium over the defect.
During the CS, the actual state of the uterine scar was determined whether it is intact or there is a scar dehiscence and
Summary and Conclusion
100
these findings were compared to the ultrasonographic findings to determine the usefulness of the first trimesteric transvaginal U/S in assessment of uterine scar status.
he number of deliveries by CS has been increasing steadily worldwide in recent decades. Although it is often assumed that CS improves neonatal outcomes, there is no hard scientific evidence to support this.
The safety of CS, however, has increased owing to improvements in surgical and anaesthetic techniques, increased safety of blood transfusion and routine use of antibiotics and thromboprophylaxis.
As a result of this operation late scar dehiscence may occur, which may lead to uterine rupture in a subsequent pregnancy. Uterine rupture is an uncommon but potentially catastrophic.
Studies have shown that the risk of uterine rupture in the presence of a defective scar is directly related to the degree of thinning of the lower uterine segment.
A number of objective methods have been used to evaluate the cesarean scar defects. These include hysteron-salpingogram as anterior out pouching. As non invasive alternative procedures, MRI and CT scan also be diagnostic.
Several studies have compared the thickness of the LUS measured by ultrasound with the thickness assessed during surgery.
T
Summary and Conclusion
99
Although most of the attention has focused on second- and third-trimester diagnosis of abnormal placental insertion and risk of rupture during labor in patients with a history of LSCS. It may be that first-trimester screening could allow early recognition of patients at risk for any of these perinatal complications.
Indeed, the first trimester is increasingly considered as a starting point for stratifying patients at risk of subsequent obstetric complications, such as placenta previa.
The first trimester is possibly the best time to achieve visualization of the scar and its relationship with the trophoblast, which may suggest or rule out abnormal placental insertions.
The aim of the current study was to assess the efficacy of the first trimesteric transvaginal ultrasound in prediction of Cesarean scar dehiscence in women with previous CS comparing to intra operative visual assessment of the scar at term.
In the current study 185 women with history of previous one CS were recruited from the obstetric outpatient clinic of Ain Shams university maternity hospital and Dar Elshefa hospital.
Transvaginal ultrasound was done in the Ultrasound Unit in Ain shams university maternity hospital. Evaluation of CS scar was done, using measurement of the thickness of the remaining myometrium over the defect.
During the CS, the actual state of the uterine scar was determined whether it is intact or there is a scar dehiscence and
Summary and Conclusion
100
these findings were compared to the ultrasonographic findings to determine the usefulness of the first trimesteric transvaginal U/S in assessment of uterine scar status.
Other data
| Title | First Trimester Uterine Scar Assessment by Transvaginal Ultrasound | Other Titles | تقييم ندبات الرحم فى الثلث الأول من الحمل بالموجات فوق الصوتية عبر المهبل | Authors | Shaymaa Mohammed Sameer AbdelAall | Issue Date | 2014 |
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