Vol. 6, Issue 2, Part A (2024)

Introduction: Uterine scar dehiscence is a common complication of caesarean delivery, which increases the risk of uterine rupture. Uterine rupture is a complete division of all three layers of the uterus: the perimetrium, myometrium, and endometrium; while uterine dehiscence is considered an incomplete division of the three layers, allowing visibility of the foetus through the perimetrium.
Objective: To determine the risk factors for uterine scar dehiscence among women undergoing repeat cesarean delivery.
Methodology: This is a prospective observational study conducted at Dept. of Obst & Gynae, Shaheed Tazuddin Ahmad Medical College & Hospital, Gazipur, Bangladesh from July to December 2022. Total 120 women who underwent repeat LSCS and uterine scar dehiscence recorded by the operating surgeon were eligible. Data was collected regarding maternal age, obstetrical history, associated risk factors and outcome.
Results: Total 120 women with Uterine Scar Dehiscence were studied and risk factors determined. In the age groups, maximum uterine scar dehiscence were noted in age group of 20-25 years (38.3%) and 26-30 years (34.1%) and the number of pregnancies are also seen more in these age groups. however significant number of uterine scar dehiscence were noted in age group 31-35 years (24.1%). The rate of uterine scar dehiscence was found to be associated with increased pre-term delivery, around 30.8% in our study. This leaded to increased neonatal pre-term delivery, low birth weight (19.1%) and NICU admissions. Inter-delivery interval <24 months was observed in 23.3%, associated with pre-term delivery in 30.8%.
Conclusion: Uterine scar dehiscence is not uncommon among women undergoing elective repeat cesarean delivery. It is a clinically occult benign condition identified incidentally at repeat caesarean delivery and is not associated with any adverse maternal or perinatal outcome compared to uterine rupture which is associated with significant morbidity.