Ultrasound Evaluation of Lower Uterine Segment in Pregnant Patient with History of Hysterotomy

Abstract

Background: ultrasonography has been widely used in the field of obstetrics & gynecology. Development of more sophisticated technology in ultrasonography & the huge amount of studies & education by physicians makes ultrasonographic examination one of the most useful diagnostic techniques in obstetrics & gynecology. Objective: In this study we aimed to evaluate the gravid uterus in women with a history of previous, 1 or more hysterotomy, in all 3 trimesters by Trans-vaginal ultrasound (TVUS). Patients and Methods: This is a prospective, case-control, observational study. The study was carried out in a private Obstetrics & Gynaecology center Wally center in Fayoum city. The study was carried out in the period from December 2017 to December 2018. Initially, 100 patients were enrolled, but at the end of the study only 67 patients were involved in the study. Results: The distance between the leading edge of the placenta to the internal OS is the diagnostic accretion. This difference between the 5 groups regarding this distance was found to be highly significant (p-value= 0.001) across all 3 trimesters, which proves that repeated CS deliveries is a major risk factor for placenta praevia. There were 1 case, 3 cases & 2 cases of low-lying placenta found in groups 3, 4 & 5, respectively. Conclusion: Cesarean section scar pregnancy and rupture uterus are both rare events and were not found in the sample of this prospective study. However, they are both very important to diagnose as early as possible to prevent serious morbidity and even mortality.