Assessment of Lower Segment Ceasarean Scar by Transvaginal Ultrasound and MRI

Objective: To assess lower segment scar on ultrasound and MRI followed by comparing with the intraoperative findings of scar in lower uterine segment. Methods: This was a prospective observational comparative study with a sample size of 40. Patients were recruited from the antenatal clinic. The study included women with previous one lower segment cesarean section and not willing for trial of labour after birth and those with previous one lower segment cesarean with no H/O previous vaginal birth. Routine obstetric examination was done at 36-37 weeks POG. A detailed obstetric ultrasound was performed. Patients before undergoing elective repeat lower segment cesarean section had Transvaginal ultrasonography (TVS) and MRI for evaluation of previous cesarean uterine scar. Result: The mean age of study group was 29.28 ± 3.48 yrs. The mean scar thickness in study group on TVS was 3.36 mm ± 1.2 mm. Mean scar thickness on MRI was 3.5 mm± 1.12mm. During intra-operative assessments of scar, in 82.5% cases scar was intact while in 15% cases scar was dehiscent. There was a positive correlation between all three modalities i.e. TVS , MRI and intra-operative findings. Conclusion: In this observational comparative done to correlate scar thickness measured on TVS and MRI with the intra-operative scar thickness, based on the findings we conclude that both TVS and MRI can be used for measurement of scar thickness.