Scar; Previous Cesarean Section Clinical Trial
Official title:
Präoperative Und Intraoperative Sonografische Beurteilung Des Unteren Uterinsegmentes im Rahmen Der Re-Sectio Caesarea - Eine Ultraschall- Methoden-Vergleichsstudie
This prospective, clinical, observational study compares preoperative and intraoperative
sonographic assessment of lower uterine segment of women who underwent ≥ second cesarean
section.
It is the purpose of the study to assess transabdominal (linear/convex ultrasound probe) and
transvaginal approach versus intraoperative sonographic assessment of lower uterine segment.
In 1991, 126.297 (15.3%) women delivered by caesarean section in Germany. Since then, the
rate of caesarean section increased steadily over the next 20 years, reaching up to 32.2% in
2011 [https://www.destatis.de]. The absolute risk of uterine rupture in vaginal birth after
Caesarean section is 1 in 100 deliveries. The risk of perinatal death or the outcome of
extremely neurological impairment is 1 in 1000 deliveries [Cunningham et al., 2009].
Statistically more than 300 pregnant women with a prior caesarean delivery visit daily
ultrasound departments of german hospitals to investigate the C-section scar before
delivery. They have one important question: Is it possible to predict successful trial of
labor after cesarean delivery? [AQUA-Institut] The information for the risk of uterine
rupture remains insufficient based only on ultrasonography assessment [Varner et al., 2012].
The measurement technique for lower uterine segment (myometrial) thicknesses in the third
trimester have been described by several authors. Using a combination of preoperative
transvaginal and transabdominal (linear/convex probe) ultrasound, we compare with
intraoperative sonographic assessment of lower uterine segment of women who underwent ≥
second cesarean section.
The aim of the present study is to assess transabdominal (linear/convex ultrasound probe)
and transvaginal approach versus intraoperative sonographic assessment of lower uterine
segment.
This will allow the investigators to draw conclusions regarding the best method to
assessment of lower uterine segment (myometrial) thickness in the third trimester to predict
successful trial of labor after cesarean delivery.
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Observational Model: Cohort, Time Perspective: Prospective
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