JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v3i2.2229 jpsim.v3i2.2229 Original Research Diagnostic Accuracy of Transabdominal Ultrasonography for Prediction of Uterine Dehiscence in Females Presenting with a Previous Cesarean Section Nasir Kiran dockirannasir@gmail.com * Mutee-us-Salam M. Maqsood Maria Maqsood Shumaila Nisa Rakhshanda Niazi Qudsia DHQ Hospital Mianwali LDD Deptt Govt of Punjab Lady Aitchison Hospital Lahore BHU Sargodha *Correspondence: Kiran Nasir (dockirannasir@gmail.com) 15 06 2022 2022 3 2 149 152 28 12 2021 23 03 2022 Copyright © 2022 The Author(s) 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective

To assess the diagnostic accuracy of trans-abdominal ultrasonography for the prediction of uterine dehiscence in females presenting with a previous one cesarean section

 Methodology

This Cross-sectional study was undertaken in Department of Obstetrics & Gynaecology, Moula Bakhsh DHQ Teaching Hospital Sargodha; Livestock & Dairy Development Department, Government of Punjab. Informed consent was taken from all the patients and demographic information was obtained. The transabdominal ultrasound was performed by a single senior radiologist having 4 years’ residency experience. Scar thickness was measured and patients were labeled as positive or negative. Then during surgery, scar thickness was measured. All the collected data was entered and analyzed on SPSS V. 20.

 Results

The mean age of females was 30.45±6.01 years. The mean gestational age was 36.82±1.44 weeks. The sensitivity, specificity and diagnostic accuracy of the TAS was 91.8%, 88.76% and 90% respectively taking intraoperative as gold standard.

 Conclusion

The TAS is useful tool with high accuracy for examination of uterus for uterine dehiscence in females having previous one cesarean delivery

 Keywords Cesarean Section Transabdominal Ultrasonography Uterine Dehiscence References Robert G, Cornwell J. What matters to patients? Policy recommendations. A report for the Department of Health and NHS Institute for Innovation and Improvement. NHS Institute for Innovation & Improvement 2011. Obstetricians ACo, Gynecologists. ACOG Practice bulletin no. 115: Vaginal birth after previous cesarean delivery. Obstet Gynecol. 2010;116(2):450. Jastrow N, Chaillet N, Roberge S, Morency A-M, Lacasse Y, Bujold E. Sonographic lower uterine segment thickness and risk of uterine scar defect: a systematic review. J Obstet Gynaecol Can. 2010;32(4):321-7. Cheung V. Sonographic measurement of the lower uterine segment thickness in women with previous caesarean section. J Obstet Gynaecol Canada. 2005;27(7):674-81. Michaels WH, Thompson HO, Boutt A, Schreiber FR, Michaels SL, Karo J. Ultrasound diagnosis of defects in the scarred lower uterine segment during pregnancy. Obstet Gynecol. 1988;71(1):112-20. Kok N, Wiersma I, Opmeer B, De Graaf I, Mol B, Pajkrt E. Sonographic measurement of lower uterine segment thickness to predict uterine rupture during a trial of labor in women with previous Cesarean section: a meta‐analysis. Ultras Obstet Gynecol. 2013;42(2):132-9. Rozenberg P, Goffinet F, Philippe H, Nisand I. Ultrasonographic measurement of lower uterine segment to assess risk of defects of scarred uterus. The Lancet. 1996;347(8997):281-4. Mohammed ABF, Al-Moghazi DA, Hamdy MT, Mohammed EM. Ultrasonographic evaluation of lower uterine segment thickness in pregnant women with previous cesarean section. Middle East Fertil Soc J. 2010;15(3):188-93. Abosrie M, Farag MAEM. Prediction of cesarean section scar dehiscence before delivery using three-dimensional transabdominal ultrasonography. Benha Med J. 2015;32(2):101. Timor-Tritsch I, Rottem S, Boldes R. Scanning the uterus. Transvaginal Sonography: Elsevier New York; 1988. p. 27. Quant HS, Friedman AM, Wang E, Parry S, Schwartz N. Transabdominal ultrasonography as a screening test for second-trimester placenta previa. Obstet Gynecol. 2014;123(3):628-33. Ofili‐Yebovi D, Ben‐Nagi J, Sawyer E, Yazbek J, Lee C, Gonzalez J, et al. Deficient lower‐segment Cesarean section scars: prevalence and risk factors. Ultrasound in Obstet Gynecol. 2008;31(1):72-7. Kirkinen P. Ultrasonography of the lower uterine segment after multiple caesarean sections. Ann Med. 1990;22(2):137-9. Sen S, Malik S, Salhan S. Ultrasonographic evaluation of lower uterine segment thickness in patients of previous cesarean section. Int J Gynecol Obstet. 2004;87(3):215-9. Hernandez-Andrade E, Romero R, Ahn H, Hussein Y, Yeo L, Korzeniewski SJ, et al. Transabdominal evaluation of uterine cervical length during pregnancy fails to identify a substantial number of women with a short cervix. J Maternal-Fetal Neonat Med 2012;25(9):1682-9.