Preoperative diagnosis of dehiscence of the lower uterine segment in patients with a single previous Caesarean section

Preoperative diagnoses were checked during surgery in 39 patients who under went elective repeat Caesarean section with (n = 20) and without (as contro l, n = 19) a preoperative diagnosis of wall dehiscence (thinning) of the lo wer uterine segment (LUS). All patients were examined manually and by ultra sonography at 36 weeks gestation before labour. A preoperative diagnosis of wall dehiscence was made when the wall thickness was less than 2 mm and/or the patient felt pain and tenderness inthe LUS. Surgical findings of dehis cence were defined as a subperitoneal separation of the uterine scar in the LUS. The sensitivity and specificity of our ultrasonographic evaluations w ere found to be 100% and 83% (p < 0.05), respectively. On the other hand, t here were no surgical findings of dehiscence in patients who felt pain and tenderness in the LUS with a wall thickness greater than 2 mm, nor among th ose in the control group.