Journal of Nippon Medical School: Vol.67 No.5 page.352

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ArticleTitle Prediction of Uterine Dehiscence by Measuring Lower Uterine Segment Thickness Prior to the Onset of Labor (Evaluation by Transvaginal Ultrasonography)

AuthorList Hirobumi Asakura, Akihito Nakai, Gen Ishikawa, Shyunji Suzuki and Tsutomu Araki

Affiliation Department of Obstetrics and Gynecology, Nippon Medical School

Language EN

Volume 67

Issue 5

Year 2000

Page 352-356

Received May 19, 2000

Accepted July 4, 2000

Keywords uterine dehiscence, uterine rupture, ultrasonogrphy, lower uterine segment, VBAC

Abstract Objective: Lower uterine segment thickness was measured by transvaginal ultrasound examination and its correlations with the occurrence of uterine dehiscence and rupture was examined. Methods: The thickness of the muscular layer of the lower uterine segment was measured in 186 term gravidas with previous uterine scars and its correlation with uterine dehiscence/rupture was investigated. Results: Uterine dehiscence was found in 9 cases or 4.7%. There were no cases of the uterine rupture. The thickness of the lower uterine segment among the gravidas with dehiscence was significantly less in than those without dehiscence (p< 0.01). The cut-off value for the thickness of the lower uterine segment was 1.6 mm as calculated by the receiver operating characteristic curve. The sensitivity was 77.8%; specificity 88.6%; positive predictive value 25.9%; negative predictive value 98.7%. Conclusion: Measurement of the lower uterine segment is useful in predicting the absence of dehiscence among gravidas with previous cesarean section. If the thickness of the lower uterine segment is more than 1.6 mm, the possibility of dehiscence during the subsequent trials of labor is very small.

Correspondence to Hirobumi Asakura, Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
asakura hirobumi@om.nms.ac.jp

ArticleTitle	Prediction of Uterine Dehiscence by Measuring Lower Uterine Segment Thickness Prior to the Onset of Labor (Evaluation by Transvaginal Ultrasonography)
AuthorList	Hirobumi Asakura, Akihito Nakai, Gen Ishikawa, Shyunji Suzuki and Tsutomu Araki
Affiliation	Department of Obstetrics and Gynecology, Nippon Medical School
Language	EN
Volume	67
Issue	5
Year	2000
Page	352-356
Received	May 19, 2000
Accepted	July 4, 2000
Keywords	uterine dehiscence, uterine rupture, ultrasonogrphy, lower uterine segment, VBAC
Abstract	Objective: Lower uterine segment thickness was measured by transvaginal ultrasound examination and its correlations with the occurrence of uterine dehiscence and rupture was examined. Methods: The thickness of the muscular layer of the lower uterine segment was measured in 186 term gravidas with previous uterine scars and its correlation with uterine dehiscence/rupture was investigated. Results: Uterine dehiscence was found in 9 cases or 4.7%. There were no cases of the uterine rupture. The thickness of the lower uterine segment among the gravidas with dehiscence was significantly less in than those without dehiscence (p< 0.01). The cut-off value for the thickness of the lower uterine segment was 1.6 mm as calculated by the receiver operating characteristic curve. The sensitivity was 77.8%; specificity 88.6%; positive predictive value 25.9%; negative predictive value 98.7%. Conclusion: Measurement of the lower uterine segment is useful in predicting the absence of dehiscence among gravidas with previous cesarean section. If the thickness of the lower uterine segment is more than 1.6 mm, the possibility of dehiscence during the subsequent trials of labor is very small.
Correspondence to	Hirobumi Asakura, Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan asakura hirobumi@om.nms.ac.jp