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Sonographic assessment of lower uterine segment thickness at term in women with previous cesarean delivery

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Aim

The purpose of this study was to establish the validity of abdominal sonographic evaluation of lower uterine segment (LUS) thickness in full-term pregnancies with a single previous cesarean section, and to assess the usefulness of measuring LUS thickness in predicting the risk of uterine dehiscence.

Methods

Three hundred and thirty-six women with a single previous cesarean section who had an ultrasound measurement of the LUS thickness in pregnancy were enrolled. Abdominal sonographic assessment of LUS was carried out within 2 weeks of delivery. Sonographic measurements were correlated visual finding of a uterine scar at the time of the iterative cesarean section. Receiver operating curve analyses has been used to determine the detection rate and the risk of each actual value of LUS thickness vs. a thin uterine scar.

Results

In our present study, 2.5 mm was considered the critical cut-off value of the LUS thickness. This critical cut-off value was derived from the ROC curve with sensitivity, specificity, PPV, and NPV of 90.9, 84, 71.4, and 95.5 %, respectively (using transabdominal ultrasound). The linear regression model analysis revealed that full LUS thickness of <2.5 mm was the only factor to be correlated with translucent lower uterine segment (C3) (8.8 vs. 0 %; P = 0.02).

Conclusion

Full LUS thickness of <2.5 mm is associated with a higher risk of uterine dehiscence.

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Authors and Affiliations

  1. Gynekologické centrum Nitra s.r.o, Nitra, Slovakia

    Peter Uharček

  2. Department of Obstetrics and Gynecology, Faculty Hospital Nové Zámky, Slovenská 11, 940 34, Nové Zámky, Slovakia

    Peter Uharček

  3. ULMUS s.r.o, Hlohovec, Slovakia

    Alexander Brešťanský

  4. Faculty Hospital Nitra, Nitra, Slovakia

    Alexander Brešťanský, Jozef Ravinger, Andrea Máňová & Mária Zajacová

Authors
  1. Peter Uharček
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  2. Alexander Brešťanský
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  3. Jozef Ravinger
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  4. Andrea Máňová
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  5. Mária Zajacová
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Correspondence to Peter Uharček.

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Uharček, P., Brešťanský, A., Ravinger, J. et al. Sonographic assessment of lower uterine segment thickness at term in women with previous cesarean delivery. Arch Gynecol Obstet 292, 609–612 (2015). https://doi.org/10.1007/s00404-015-3687-0

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  • DOI: https://doi.org/10.1007/s00404-015-3687-0

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