Feasibility of prediction of cesarean section scar dehiscence in the third trimester by three-dimensional ultrasound

Abstract

Purpose: To assess the role of three-dimensional (3D) ultrasound mutiplanar view in prediction of cesarean section (CS) scars dehiscence.

Subjects and methods: One hundred pregnant women with previous CS scars were investigated by ultrasound to measure the scar thickness by 2D ultrasound and to depict the uterine wall by 3D coronal plane, using 3D multiplanar view. Straight line cut section by 3D multiplanar view was used and prediction of dehiscence was by detecting fenestration of the wall.

Results: Operative findings revealed that 95 cases (95%) of the studied group had intact uterine scar, while dehiscence was detected among five ladies (5%). Validity of 3D U/S versus operative findings revealed a sensitivity of 83.3%, specificity 100%, positive predictive value 100%, negative predictive value 99% and accuracy 99%. C technique was superior to straight line technique in multiplanar view for assessment of the scars.

Conclusion: Three-dimensional ultrasound is useful in prediction of dehiscent scars during pregnancy with perfect sensitivity. Machines with the availability of C dissection in the multiplanar view are more useful in this field.

Keywords: Cesarean section; multiplanar view; three-dimensional ultrasound.