Status of Scar in Repeat Cesarean Section in a Tertiary Hospital
Keywords:Maternal mortality, Repeat cesarean section, Uterine rupture
Introduction: In modern Obstetrics, with rising trends of primary cesarean section (CS) for fetal and maternal interests, pregnancy over the scarred uterus is a challenge to all treating obstetricians. Despite the method of suturing of the cesarean scar, its fate in next pregnancy is still not measurable. Objective of this study was to evaluate the status of previous cesarean scar during repeat cesarean section (RCS) and calculate the maternal morbidity in those cases in a tertiary hospital.
Methods: It was a descriptive, retrospective study conducted at department of Obstetrics of Lumbini Medical College Teaching Hospital. The study was conducted from 15th July 2014 to 14thJuly 2015. The data were retrieved from the department of Medical Records. Women undergoing RCS were enrolled. The status of scar was evaluated in terms of intact scar, scar rupture, scar dehiscence, thin lower uterine segment, scar placenta previa, and adhesions as indicator of scar integrity.
Results: There were 534 (25.4%) CS among 2,098 deliveries during the study period. Ninety one (17.04%) of them were RCS. Elective RCS were 73.6% (n=67), and emergency RCS were 26.4% (n=24). Eighty two (90.1%) women had RCS once and nine (9.9%) had RCS for second time. Scar was intact in 22 (91.6%), scar dehiscence in one (8.3%), scar with adhesions in one (8.3%) among emergency RCS and intact in 53 (91.3%) and scar with adhesions in five (8.7%) among elective RCS. There was no scar dehiscence and no scar rupture in two RCS women. Adhesions were documented twice higher in women whose primary CS was undertaken outside our hospital. Placenta previa and placenta accreta each were found in two cases.
Conclusion: Most of the scars of repeat cesarean section were healthy with no scar rupture. We can consider trial of labor for scarred uterus with strict vigilance and in need, CS is always an option.
J. Lumbini. Med. Coll. Vol 4, No 1, Jan-June 2016, page: 42-45
How to Cite
LicenseThe Journal of Lumbini Medical College (JLMC) publishes open access articles under the terms of the Creative Commons Attribution(CC BY) License which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
JLMC requires an exclusive licence allowing to publish the article in print and online.
The corresponding author should read and agree to the following statement before submission of the manuscript for publication,
In submitting an article to Journal of Lumbini Medical College (JLMC) I certify that:
- I am authorized by my co-authors to enter into these arrangements.
- I warrant, on behalf of myself and my co-authors, that:
- the article is original, has not been formally published in any other peer-reviewed journal, is not under consideration by any other journal and does not infringe any existing copyright or any other third party rights;
- I am/we are the sole author(s) of the article and have full authority to enter into this agreement and in granting rights to JLMC are not in breach of any other obligation;
- the article contains nothing that is unlawful, libellous, or which would, if published, constitute a breach of contract or of confidence or of commitment given to secrecy;
- I/we have taken due care to ensure the integrity of the article. To my/our - and currently accepted scientific - knowledge all statements contained in it purporting to be facts are true and any formula or instruction contained in the article will not, if followed accurately, cause any injury, illness or damage to the user.
Please visit Creative Commons web page for details of the terms.