Uterine dehiscence is usually used to refer to the process of gradual myometrial rupture without a rupture of membranes. However, the term is used synonymously with uterine rupture by some authors. It is often described in the context of a cesarean section scar where it is also termed an incisional dehiscence5. Dehiscence can be partial or complete.
Generally, uterine dehiscence is clinically occult and is not associated with any adverse maternal or perinatal outcomes.
Interestingly classical transverse cesarean section scars are more likely to rupture beforelabor, whereas lower uterine segment cesarean section (LSCS) scars tend to rupture afterlabor.
Treatment and prognosis
In one study it was suggested that preterm delivery and non-progress of labor were independent risk factors for uterine scar dehiscence. By contrast, parity was found to have a protective effect against dehiscence 8.
1. Benson C B,MD. Ultrasonography in obstetrics and gynocology, a practical approach. Thieme. (2007) ISBN:1588906124. Read it at Google Books - Find it at Amazon
2. Asakura H, Nakai A, Ishikawa G et-al. Prediction of uterine dehiscence by measuring lower uterine segment thickness prior to the onset of labor: evaluation by transvaginal ultrasonography. J Nippon Med Sch. 2000;67 (5): 352-6. J Nippon Med Sch (link) - Pubmed citation
3. Pollio F, Staibano S, Mascolo M et-al. Uterine dehiscence in term pregnant patients with one previous cesarean delivery: growth factor immunoexpression and collagen content in the scarred lower uterine segment. Am. J. Obstet. Gynecol. 2006;194 (2): 527-34. doi:10.1016/j.ajog.2005.07.048 - Pubmed citation
7. Kaakaji Y, Nghiem HV, Nodell C et-al. Sonography of obstetric and gynecologic emergencies: Part I, Obstetric emergencies. AJR Am J Roentgenol. 2000;174 (3): 641-9. AJR Am J Roentgenol (full text) - Pubmed citation
8. Bashiri A, Burstein E, Rosen S et-al. Clinical significance of uterine scar dehiscence in women with previous cesarean delivery: prevalence and independent risk factors. J Reprod Med. 2008;53 (1): 8-14. Pubmed citation
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