Incidence and Risk Factors of Uterine Scar Dehiscence Identified at Elective Repeat Cesarean Delivery: A Case-Control Study

Mohamad K. Ramadan, Samar Kassem, Saadeddine Itani, Loubna Sinno, Sara Hussein, Rabih Chahin, Dominique A. Badr

Abstract


Background: The aim of this study was to determine the rate of uterine scar dehiscence among women undergoing elective repeat cesarean delivery and to investigate associated risk factors.

Methods: This was a retrospective case-control study of patients with previous one or more lower segment transverse cesarean incisions giving birth by elective repeat cesarean delivery at two tertiary-care centers over a period of 1 year. Demographic data, previous and current obstetric events were recorded and compared among women with or without uterine scar dehiscence.

Results: Among 588 patients included in this study, 27 cases of uterine scar dehiscence were identified with an incidence of 4.6%. This rate was not affected by maternal age, parity, co-morbidity, twin gestation, preoperative labor or previous preterm cesarean delivery. Factors significantly associated with uterine scar dehiscence were “preterm delivery” (OR: 2.76, 95% CI: 1.18 - 6.42), “tertiary cesarean delivery or higher” (OR: 2.56, 95% CI: 1.14 - 5.75) and “inter-delivery interval <= 24 months” (OR: 2.38, 95% CI: 1.04 - 5.44). No immediate adverse maternal or neonatal complications were noted.

Conclusions: Uterine scar dehiscence is not uncommon among women undergoing elective repeat cesarean delivery. Increased risk was associated with preterm delivery, tertiary cesarean delivery or higher and short inter-delivery interval of <= 24 months.




J Clin Gynecol Obstet. 2018;7(2):37-42
doi: https://doi.org/10.14740/jcgo481w


Keywords


Uterine scar dehiscence; Elective repeat cesarean deliveries; Risk factors; Preterm delivery; Inter-delivery interval

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