Sonographic evaluation of post-Cesarean lower uterine segment in pregnant Nigerian women

Abstract

Aims/Purpose:

This study was done to determine if there are significant morphological differences between a previously sectioned and non-operated lower uterine segment in an African population.

Methods:

This was a prospective, descriptive, comparative study of thirty-eight pregnant women with previous Cesarean section and 45 pregnant women with no previous uterine surgery. They had transabdominal sonographic measurement of their lower uterine segment thickness between 35 and 37 weeks gestation. Mann-Whitney U test was used for comparison of means.

Results:

The lower uterine segment was significantly thinner in women with previous Cesarean group compared to the controls (mean of 4.9 ± 2.5 mm and 3.4 ± 2.2 mm versus 6.4 ± 2.8 mm and 4.5 ± 2.2mm for full and myometrial thicknesses, respectively; P= 0.006 and 0.007, respectively). Normal lower uterine segment appearance and thicknesses were seen in the majority of previously sectioned women. The previous scar site was identified in 8 (10.7%) of women with previous scar.

Conclusion:             

In women desirous of attempted vaginal birth after a previous Cesarean section, ultrasonography of the lower uterine segment could be done to rule-out abnormal scarring and thus aid in planning a safe trial of scar.