Relationship of Interpregnancy Interval with Ultrasonographic Measurement of Lower Uterine Segment Caesarean Scar Thickness

Abstract Background: There is a rise in the caesarean section rates throughout the world due to which obstetricians see more women with caesarean section scar. As a result of this operation, late scar dehiscence may occur leading to uterine rupture in a subsequent pregnancy. Abundant works have been done regarding complication and outcome of caesarean section. However, very limited work is noticed regarding the relationship of interpregnancy interval with caesarean scar thickness. Objective: To find out the relationship of interpregnancy interval (IPI) with ultrasonographic measurement of lower uterine segment caesarean scar thickness at 3rd trimester. Methods: This cross-sectional analytical study was conducted at the Department of Gynaecology and Obstetrics in Sir Salimullah Medical College and Mitford Hospital (SSMC & MH) for a period of six months. Pregnant women of 36 to 40 weeks with history of 1 previous caesarean section were approached for inclusion in the study. Eighteen (18) months interpregnancy interval were used to categorize the study population into two groups. Group I is ≥ 18 months IPI & group II is < 18 months IPI. Written informed consent was taken from each subject and ethical issues were ensured properly. Data collection was done with an aid of a preformed questionnaire. Collected data was analyzed by the SPSS 23. Results: Among 50 study participants, mean age was 23.53±3.65 (SD) years in group I and 23.54±3.95 (SD) in group II. Majority of study population were well-nourished (62.20% in group I and 56.43% in group II). About 64% of patients’ IPI was ≥ 18 months (group I) and 36% patients’ IPI was < 18 months (group II). In group II, majority patients (88.90%) scar thickness was <2.5 mm and in group I only 6.20% patients’ scar thickness was <2.5 mm. Scar tenderness was also associated with IPI where most of the patients of group II were observed to be present with scar tenderness. Conclusion: Short interpregnancy interval is proportionately associated with scar thickness in our settings. However, further study with larger sample size is recommended.