Sonographic Evaluation of the Wall Thickness of the Lower Uterine Segment in Patients with Previous Cesarean Section

Abstract

In pregnant women with a history of cesarean section, wall thickness of the lower uterine segment may help determine the risk and safety of vaginal delivery. Determination of wall thickness may help identify the potential risk of uterine rupture in pregnant women who do not wish to have another cesarean section or who are not eligible for surgery due to other systemic disorders. In this study, 50 pregnant women with previous cesarean sections were evaluated with ultrasound preoperatively, and measurements of the lower uterine segment wall thickness were compared with intraoperative assessment of uterine thinning. These findings correlated highly with each other (sensitivity: 100%; specificity: 82% positive predictive value: 87%; negative predictive value: 100%), suggesting the reliability and safety of ultrasound in evaluating uterine wall thickness. (C) 1996 John Wiley & Sons, Inc.