Misao Fukuda1, Kiyomi Fukuda1, Takashi Shimizu2, Emmanuel Bujold3. 1. M&K Health Institute, Hyogo, Japan. 2. Shimizu Women's Clinic, Hyogo, Japan. 3. Department of Obstetrics and Gynaecology, Centre de Recherche du CHU de Québec, Faculty of Medicine, Université Laval, Quebec City QC.
Abstract
OBJECTIVES: To evaluate the normal ranges of lower uterine segment (LUS) thickness throughout pregnancy in women without a previous cesarean and to evaluate the relationship between ultrasound and intraoperative LUS thickness. METHODS: We assessed LUS thickness using transabdominal and transperineal longitudinal scan at each week of gestation, during labour, and in the postpartum period in 1000 pregnant women without previous CS. Secondly, we assessed LUS thickness immediately before CS (using ultrasound) and intraoperatively (using ophthalmic calipers) immediately before delivery of the fetus in 35 women with a previous CS and 29 women without previous CS undergoing elective CS before labour. RESULTS: We performed 20 307 LUS thickness measurements in between 119 and 944 women at each week of gestation, in 944 women during labour, and in 936 women after delivery. We observed a strong relationship between transabdominal and transperineal ultrasound (P < 0.001) and an inverse correlation between LUS thickness and gestational age (P < 0.001), with a mean thickness of 5.1 ± 1.4 mm at 20 weeks, 3.6 ± 1.3 mm at 30 weeks, and 2.3 ± 0.6 mm at 40 weeks of gestation. In women undergoing elective CS, we observed a strong relationship between antepartum and intraoperative LUS thickness (P < 0.001), with mean thicknesses of 2.2 ± 0.7 mm in 28 women without thinning of LUS; 0.8 ± 0.1 mm in four women with grade II uterine scar dehiscence; and 0.4 ± 0.1 mm in three women with grade III dehiscence. A LUS myometrial thickness less than 1.2 mm could have predicted all grade II and grade III uterine scar dehiscences without false-positive cases. CONCLUSION: LUS thickness decreases with gestational age and correlates strongly with the intraoperative LUS thickness in women with a previous CS.
OBJECTIVES: To evaluate the normal ranges of lower uterine segment (LUS) thickness throughout pregnancy in women without a previous cesarean and to evaluate the relationship between ultrasound and intraoperative LUS thickness. METHODS: We assessed LUS thickness using transabdominal and transperineal longitudinal scan at each week of gestation, during labour, and in the postpartum period in 1000 pregnant women without previous CS. Secondly, we assessed LUS thickness immediately before CS (using ultrasound) and intraoperatively (using ophthalmic calipers) immediately before delivery of the fetus in 35 women with a previous CS and 29 women without previous CS undergoing elective CS before labour. RESULTS: We performed 20 307 LUS thickness measurements in between 119 and 944 women at each week of gestation, in 944 women during labour, and in 936 women after delivery. We observed a strong relationship between transabdominal and transperineal ultrasound (P < 0.001) and an inverse correlation between LUS thickness and gestational age (P < 0.001), with a mean thickness of 5.1 ± 1.4 mm at 20 weeks, 3.6 ± 1.3 mm at 30 weeks, and 2.3 ± 0.6 mm at 40 weeks of gestation. In women undergoing elective CS, we observed a strong relationship between antepartum and intraoperative LUS thickness (P < 0.001), with mean thicknesses of 2.2 ± 0.7 mm in 28 women without thinning of LUS; 0.8 ± 0.1 mm in four women with grade II uterine scar dehiscence; and 0.4 ± 0.1 mm in three women with grade III dehiscence. A LUS myometrial thickness less than 1.2 mm could have predicted all grade II and grade III uterine scar dehiscences without false-positive cases. CONCLUSION:LUS thickness decreases with gestational age and correlates strongly with the intraoperative LUS thickness in women with a previous CS.
Authors: Shahla K Alalaf; Tarek Mohamed M Mansour; Sileem Ahmad Sileem; Nazar P Shabila Journal: BMC Pregnancy Childbirth Date: 2022-05-14 Impact factor: 3.105
Authors: Erin Marie Louwagie; Lindsey Carlson; Veronica Over; Lu Mao; Shuyang Fang; Andrea Westervelt; Joy Vink; Timothy Hall; Helen Feltovich; Kristin Myers Journal: PLoS One Date: 2021-01-28 Impact factor: 3.240