Incidence and Risk Factors of Uterine Scar Dehiscence Identified at Elective Repeat Cesarean Delivery: A Case-Control Study

Mohamad K. Ramadan, Samar Kassem, Saadeddine Itani, Loubna Sinno, Sara Hussein, Rabih Chahin, Dominique A. Badr
2018 Journal of Clinical Gynecology and Obstetrics  
The aim of this study was to determine the rate of uterine scar dehiscence among women undergoing elective repeat cesarean delivery and to investigate associated risk factors. Methods: This was a retrospective case-control study of patients with previous one or more lower segment transverse cesarean incisions giving birth by elective repeat cesarean delivery at two tertiary-care centers over a period of 1 year. Demographic data, previous and current obstetric events were recorded and compared
more » ... rded and compared among women with or without uterine scar dehiscence. Results: Among 588 patients included in this study, 27 cases of uterine scar dehiscence were identified with an incidence of 4.6%. This rate was not affected by maternal age, parity, co-morbidity, twin gestation, preoperative labor or previous preterm cesarean delivery. Factors significantly associated with uterine scar dehiscence were "preterm delivery" (OR: 2.76, 95% CI: 1.18 -6.42), "tertiary cesarean delivery or higher" (OR: 2.56, 95% CI: 1.14 -5.75) and "inter-delivery interval ≤ 24 months" (OR: 2.38, 95% CI: 1. 04 -5.44). No immediate adverse maternal or neonatal complications were noted. Conclusions: Uterine scar dehiscence is not uncommon among women undergoing elective repeat cesarean delivery. Increased risk was associated with preterm delivery, tertiary cesarean delivery or higher and short inter-delivery interval of ≤ 24 months.
doi:10.14740/jcgo481w fatcat:wpnpo3pvbncvnkuvbi2vr4thvy