Title: Role of Ultrasonography (TVS) to Increase Number of Vaginal Birth after Cesarean (VBAC & TOLAC)
Authors: Urvashi Verma, Dr Sangita Sahu, Saroj Singh, Sikha Singh, Ruchika Garg
DOI: https://dx.doi.org/10.18535/jmscr/v6i5.23
Abstract
Aim: To evaluate the efficacy of Transvaginal Sonography (TVS) to measure the thickness of scarred Lower Uterine Segment (LUS) in antenatal women at term and it association with obstetrical outcome.
Methods: This prospective study included 100 antenatal women with previous caesarean at term in study group and 100 antenatal women without H/O any uterine surgery of same profile in control group. LUS was scanned using TVS. All women were followed till delivery & further divided unto 2 groups for mode of delivery.
Results: Out of the total 100 antenatal women in study group 28 were kept for repeat elective caesarean for repeat indications for C.S. Rest 72% women underwent trial of labour with continuous maternal and fetal monitoring. Out of 72 women kept for TOL, 26 had emergency caesarean and 46 had successful VBAC. At a cut off value of scar thickness 2.5mm, the sensitivity, specificity, positive predictive value and negative predictive value was 80.6%, 83%, 70% and 90.3% respectively. It suggested that if the thickness of LUS was 2.5 mm or more, chances of vaginal delivery following trial of labour was high.
Conclusion: Antenatal ultrasonographic (2D/3D) assessment of LUS thickness near term can result a successful trial of labour is women with previous caesarean section.
Keywords: Transvaginal Sonography, Lower uterine segment, caesarean section scar, vaginal birth after cesarean section (VBAC).
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