caa a22 4500 445307307 CHVBK 20180317142617.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1007/s00404-010-1384-6 doi (NATIONALLICENCE)springer-10.1007/s00404-010-1384-6 Sonographic assessment of lower uterine segment at term in women with previous cesarean delivery [Elektronische Daten] [Pralhad Kushtagi, Suneeta Garepalli] Objective: To correlate lower uterine segment (LUS) thickness measured by abdominal sonography at term pregnancy with that measured manually using caliper at cesarean delivery and to find out minimum LUS thickness indicative of its integrity in women with previous cesarean. Methods: In 106 women with previous cesarean delivery and 68 with unscarred uterus, abdominal sonographic assessment of LUS was carried out within a week of delivery. Sonographic measurements were correlated with manual measurement of lower flap of LUS using Vernier calipers in 96 of these women (64 with previous cesarean and 32 of unscarred uterus) who had elective cesarean delivery. Results: Sonographically determined LUS was thinner among women with previous cesarean delivery than in those without (4.58 SD 1.05 vs. 4.8 SD 0.8; t=1.986; p=0.04). Women with vaginal birth after cesarean had thicker LUS than women with repeat cesarean delivery (4.4 SD 0.97 vs. 4.48 SD 1.0). The findings were not influenced by engaged fetal head status or amount of bladder fullness. Directly measured LUS thickness using Vernier calipers before delivery of the baby confirmed ultrasound measurements, but showed smaller differences between them. There were eight cases with defective uterine scar at cesarean. LUS thickness at term of 3mm provided 87.5% sensitivity and specificity, and was found to have negative predictive value of 98%. But in two of seven cases the actual LUS was not measurable despite sonographic measurement of 3mm, and there were two records of scar dehiscence in those with 3 and 4mm of LUS thickness. Conclusion: LUS thickness of 3mm measured by abdominal ultrasonography prior to delivery at term in women with previous cesarean is suggestive of stronger LUS but is not a reliable safeguard for trial of labor. Springer-Verlag, 2010 Previous cesarean delivery nationallicence Lower uterine segment thickness nationallicence Sonographic measurement nationallicence Direct caliper measurement nationallicence Kushtagi Pralhad 1, KMC Quarters Manipal University Campus, 576104, Manipal, India aut Garepalli Suneeta Kasturba Medical College, 576104, Manipal, India aut Archives of Gynecology and Obstetrics Springer-Verlag 283/3(2011-03-01), 455-459 0932-0067 283:3<455 2011 283 404 https://doi.org/10.1007/s00404-010-1384-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-010-1384-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kushtagi Pralhad 1, KMC Quarters Manipal University Campus, 576104, Manipal, India aut NATIONALLICENCE 700 1- Garepalli Suneeta Kasturba Medical College, 576104, Manipal, India aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 283/3(2011-03-01), 455-459 0932-0067 283:3<455 2011 283 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer