Retrospective Study of Incidence and Risk Factors of Uterine Scar Dehiscence Identified at Repeat Caesarean Section
Journal of Evidence Based Medicine and Healthcare
A BS T R A C T BACKGROUND Women with previous caesarean section are at increased risk of associated morbidities such as uterine scar dehiscence, scar rupture, maternal and perinatal morbidity and mortality. This study was designed to explore the incidence of uterine scar dehiscence among women undergoing repeat caesarean section and to investigate the risk factors associated with this condition in our obstetric population. METHODS A record based retrospective study of 5 years (June 2014 to May
... (June 2014 to May 2019) was conducted in the Department of Obstetrics and Gynaecology, Dr. B.R. Ambedkar Medical College and Hospital. All women with previous lower segment Caesarean section undergoing repeat Caesarean section were included in the study. Operative data was collected from OT Register and parturition book using a structured questionnaire containing general details, comorbidities, current pregnancy details or complications, risk factors and neonatal outcomes. Data was entered into Microsoft Excel data sheet and was analysed using SPSS 22 version software. Categorical data was represented in the form of frequencies and proportions. Chi -square test and Independent t test were the tests of significance. RESULTS In this study incidence of scar dehiscence was 8.1 %. Among those with preterm delivery < 37 weeks, 76.5 % had scar dehiscence, among those with tertiary caesarean delivery 70 % had scar dehiscence and among those with inter delivery interval < 24 months, 84.6 % had scar dehiscence. Among those with Apgar < 7 at 5 min, 100 % had scar dehiscence, among those with NICU admission, 18.1 % had scar dehiscence. There was no significant difference between single or double layer closure of uterine incision. CONCLUSIONS Study concludes that preterm delivery, tertiary caesarean delivery and inter delivery interval < 24 months were significantly associated with uterine scar dehiscence.