Abstract
SummarySummaryFifteen cases of lower uterine segment caesarean section scar disruption were analysed retrospectively and classified according to the severity of the disruption into three grades: (a) scar window < 3 cm; (b) scar dehiscence with intact peritoneum (c) complete scar rupture. Eight of the patients had had oxytocin augmentation of labour. The diagnosis of scar disruption was clear on clinical grounds in only a minority of cases. When the rupture was complete, scar tenderness seemed to occur despite the use of epidural analgesia. In 11 of the 12 patients delivered by caesarean section, there was fetal distress. In ten of these, the main reason for operative intervention was fetal distress. The occurrence of fetal distress in patients with a scarred uterus should immediately raise suspicion of scar disruption. There was a tendency for fetal morbidity to be worse with a major degree of scar disruption. There were two fetal deaths and no maternal deaths.
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