[The ultrasonic assessment of the cicatrix after a past cesarean section].

Abstract

A supersonic study of the lower uterine segment of pregnant women which have had a Caesarean operation in the past has been made. The aim of this study is the confirmation of the supersonic scanning as a part of the struggle for diminution of the second abdominal deliveries. Twenty-six pregnant women with anamnesis of Caesarean operation were observed. The following conditions have been kept: precise probable term of delivery, gestational period--35-37 g.w., one foetus in head position, unspoiled amniotic fluid and full urinary bladder. It is obligatory a longitudinal and cross scanning in the area of the cicatrix to be made. For the assessment of the cicatrix sufficiency the author has applied supersonic criteria known in the literature. They include: shape, thickness, incessancy, outside lines and echo structure of the lower uterine segment. The results show: the scar is sufficient in 24 women--it has a triangular form in the lower uterine segment, even outside lines, the thickness of the cicatrix is above 3-5 mm it is incessant and with homogeneous echo structure. In 2 of th pregnant women there are data for inadequacy-the form is like a balloon, the cicatrix has got thinner under 3 mm, the incessancy of the lower segment is absent-it is with defects and uneven outside lines, the echo structure is heterogeneous with predominance of increased echogenicity. According to the way of delivery the results are confirmed pathohistologically, by microscope or by manual palpation. The effectiveness of the supersonic assessment of the cicatrix has been shown.