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Thickness of the lower uterine segment: its influence in the management of patients with previous cesarean sections
- Source :
- European Journal of Obstetrics & Gynecology and Reproductive Biology. 87:39-45
- Publication Year :
- 1999
- Publisher :
- Elsevier BV, 1999.
-
Abstract
- Objective: To determine how ultrasound measurement of the lower uterine segment affects the decision about delivery for patients with previous cesarean sections (CS) and what are the consequences on cesarean section rates and uterine rupture or dehiscence. Design: Prospective open study. Patients: 198 patients: all women with a previous CS who gave birth in our department during 1995 and 1996 to an infant with a gestational age of at least 36 weeks and who underwent ultrasound measurement of their lower uterine segment (95–96 study group), compared with a similar population from 1989 to 1994 whose measurements were not provided to the treating obstetrician. Results: Among the patients with one previous CS, the vaginal delivery rate did not differ significantly during the two periods (70.3% for the 89–94 study period vs. 67.9% for the 95–96 study period, P=0.53), but the 95–96 study group experienced a significant increase in the rate of elective CS, compensated by a reduction in the rate of emergency CS (6.3% and 23.4%, respectively, for the 89–94 study period vs. 11.9% and 20.1% for the 95–96 study period, P=0.01). There was a very significant increase in the rate of vaginal delivery for the 95–96 study period among patients with two previous CS (26.7% vs. 8.0% for the 89–95 study period, P=0.01). The lower uterine segment was significantly thicker among women with a trial of labor than among those with an elective CS (4.5±1.4 mm compared with 3.8±1.5 mm; P=0.006); and the trial of labor group contained significantly fewer women with a lower uterine segment measurement less than 3.5 mm than did the elective CS group (24.0% compared with 56.6%; P
- Subjects :
- Adult
medicine.medical_specialty
Population
Uterus
Dehiscence
Oxytocin
Uterine Rupture
Pregnancy
Risk Factors
medicine
Humans
Prospective Studies
education
Ultrasonography
Gynecology
education.field_of_study
Cesarean Section
business.industry
Vaginal delivery
Obstetrics
Ultrasound
Obstetrics and Gynecology
Gestational age
medicine.disease
Vaginal Birth after Cesarean
Trial of Labor
Uterine rupture
medicine.anatomical_structure
Reproductive Medicine
In utero
Female
business
Subjects
Details
- ISSN :
- 03012115
- Volume :
- 87
- Database :
- OpenAIRE
- Journal :
- European Journal of Obstetrics & Gynecology and Reproductive Biology
- Accession number :
- edsair.doi.dedup.....b0f9ed2a0d21977007aadb9a4e0ffc6b