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Abstract
Background: Several studies using various methods have been conducted to evaluate the correlation of lower uterine cesarean section scar measurement with the risk of uterine rupture or dehiscence with relative success. Objective: To compare the accuracy of transvaginal ultrasound versus transabdominal ultrasound to assess the lower uterinecesarean section scar thickness at term and compare both with intraoperative thickness Patients and methods: Our study was conducted on 100 patients admitted for elective repeated C.S. The patients were subjected to complete general, obstetric examination and ultrasound measurement of lower uterine segment by TAS on partially full bladder and by TVS on empty bladder, and measuring actual thickness intra-operative and results were compared. Results:We found TVS to be superior over TAS for the assessment of LUS thickness. ROC curve was used to determine best cut off for prediction of scar dehiscence,cut off value was 2.45mm by TVS for prediction of scar dehiscence with sensitivity=77.9 % and specificity 86.4 %. Conclusion:Measurement of LUS thickness by TVS, if incorporated into guidelines on the management of women who have undergone a previous cesarean, could provide valuable information in planning for delivery and counseling women undergoing VBAC, by predicting its safety and success