Clinical study on the relationship of scar tenderness with scar integrity at repeat caesarean section

Authors

  • Suchita Rani Ghosh Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Mita Das Department of Obstetrics and Gynecology, Sheikh Hasina Medical College and Hospital, Tangail, Bangladesh
  • Abanti Ghosh Directorate General of Health Services, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20230787

Keywords:

Caesarean section, Abdominal, Uterine wall, Incision, Uterine rupture

Abstract

Background: Caesarean section is an operative process whereby the fetuses after the end of 28th weeks are delivered through an incision on the abdominal and uterine wall. This excludes delivery through an abdominal incision where the fetus lying free in the abdominal cavity following uterine rupture or in secondary abdominal pregnancy. The first operation carried out on a patient is referred to as an primary caesarean section. When the operation is carried out in subsequent pregnancies, it is referred to as repeat caesarean section. Caesarean section is used in cases where vaginal delivery is not either feasible or would impose undue risks on mother or baby. The aim of the study to assess the Relationship of Scar Tenderness with Scar Integrity at repeat caesarean section.

Methods: This is an observational study. The study used to be carried out in the admitted patient’s Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh. The duration of the period from April 2017 to October 2017.

Results: This study shows that the according to age of 50 Patients aged 20 to 35 years. Here out of 50 mothers the highest 23(46%) mothers belonged to 21-25 years age group. Subsequently, 15(30%), 9(18%), 2(4%) and 1(2%) belonged to 26-30 years, ≤20 years, 31-35 years and >35 years respectively. The mean age of the respondents was 23.16±5.79 (age range: 17-38) years.

Conclusions: The scar complications are highly associated with the intensity of scar tenderness. Henceforth, it can be concluded here that scar tenderness is a vital factor responsible for scar complications.

 

References

Dutta DC. Text book of obstetrics, hypertensive disorders in pregnancy. India: New central book agency; 2004:6(1);222-7.

Ofili‐Yebovi D, Ben‐Nagi J, Sawyer E, Yazbek J, Lee C, Gonzalez J, Jurkovic D. Deficient lower‐segment Cesarean section scars: prevalence and risk factors. Ultrasound Obstet Gynecol. 2008;31(1):72-7.

Mozurkewich EL, Hutton EK. Elective repeat cesarean delivery versus trial of labor: a meta-analysis of the literature from 1989 to 1999. Am J Obstet Gynecol. 2000;183(5):1187-97.

Durnwald CP, Mercer BM. Vaginal birth after Cesarean delivery: predicting success, risks of failure. J Maternal-Fetal Neonat Med. 2004;15(6): 388-93.

David M, Gross MM, Wiemer A, Pachaly J, Vetter K. Prior cesarean section-An acceptable risk for vaginal delivery at free-standing midwife-led birth centers? Results of the analysis of vaginal birth after cesarean section (VBAC) in German birth centers. Eur J Obstet Gynecol Reprod Biol. 2009;142(2):106-10.

Gaikwad HS, Aggarwal P, Bannerjee A, Gutgutia I, Bajaj B. Is scar tenderness a reliable sign of scar complications in labor?. Int J Reprod Contracept Obstet Gynecol. 2007;1(1):33-7.

Vikhareva OO, Valentin L. Risk factors for incomplete healing of the uterine incision after caesarean section. BJOG. 2010;117(9):1119-26.

Ventura SJ, Hamilton BE, Mathews TJ. Pregnancy and childbirth among females aged 10-19 years–United States, 2007-2010. MMWR. 2013;62(3):71-6.

Grivell RM, Barreto MP, Dodd JM. The influence of intrapartum factors on risk of uterine rupture and successful vaginal birth after cesarean delivery. Clin Perinatol. 2011;38(2):265-75.

Gaikwad HS, Aggarwal P, Bannerjee A, Gutgutia I, Bajaj B. Is scar tenderness a reliable sign of scar complications in labor?. Int J Reprod Contracept Obstet Gynecol. 2012;1(1):33-7.

Gutgutia I, Bajaj B. Is scar tenderness a reliable sign of scar complications in labor?. Int J Reprod Contracept Obstet Gynecol. 2010;5(1):23-7.

American College of Obstetricians and Gynecologists. Vaginal birth after previous cesarean delivery. ACOG Prac Bull. 1995;1:1-8.

Johnson C, Oriol N. The role of epidural anesthesia in trial of labor. Regional Anesthesia and Pain Medicine. 2010;15(6):304-8.

Rodriguez MH, Masaki DI, Phelan JP, Diaz FG. Uterine rupture: are intrauterine pressure catheters useful in the diagnosis? Am J Obstet Gynecol. 1989; 161(3):666-9.

Sawada M, Matsuzaki S, Nakae R, Iwamiya T, Kakigano A, Kumasawa K, Ueda Y, Endo M, Kimura T. Treatment and repair of uterine scar dehiscence during cesarean section. Clin Case Rep. 2017;5(2): 145-9.

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.

Tazion S, Hafeez M, Manzoor R, Rana T. Ultrasound Predictability of Lower Uterine Segment Cesarean Section Scar Thickness. J Coll Physicians Surg Pak. 2018;28(5):361-4.

Cheung VY. Sonographic measurement of the lower uterine segment thickness in women with previous caesarean section. J Obstet Gynaecol Canada. 2005; 27(7):674-81.

Jastrow N, Chaillet N, Roberge S, Morency AM, Lacasse Y, Bujold E. Sonographic lower uterine segment thickness and risk of uterine scar defect: a systematic review. J Obstet Gynaecol Canada. 2010; 32(4):321-7.

Mohammed AB, 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.

Rageth JC, Juzi C, Grossenbacher H. Delivery after previous cesarean: a risk evaluation. Obstet Gynecol. 1999;93(3):332-7.

Naef III RW, Ray MA, Chauhan SP, Roach H, Blake PG, Martin JN. Trial of labor after cesarean delivery with a lower-segment, vertical uterine incision: is it safe?. Am J Obstet Gynecol. 1995;172(6):1666-74.

Davey MR, Moodley J, Hofmeyr GJ. Labour after caesarean section--the problem of scar dehiscence. South Af Med J. 1987;71(12):766-8.

Al‐Zirqi I, Stray‐Pedersen B, Forsén L, Daltveit AK, Vangen S, NUR group. Validation study of uterine rupture registration in the Medical Birth Registry of Norway. Acta Obstet Gynecol Scand. 2013;92(9): 1086-93.

Thisted DL, Mortensen LH, Hvidman L, Rasmussen SC, Larsen T, Krebs L. Use of ICD-10 codes to monitor uterine rupture: validation of a national birth registry. European J Obstet Gynecol Reprod Biol. 2014;173:23-8.

Macones GA, Cahill AG, Stamilio DM, Odibo A, Peipert J, Stevens EJ. Can uterine rupture in patients attempting vaginal birth after cesarean delivery be predicted? Am J Obstet Gynecol. 2006;195(4):1148-52.

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Published

2023-03-28

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Original Research Articles