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Objective <p>To understand the clinical presentation, obstetric profile, and outcome of scar dehiscence (grade III/IV scar) among women with a previous caesarean.</p> Methods <p>This study is a secondary analysis of an ICMR-funded project (June 2021 to July 2024). After obtaining the institute's ethical clearance and informed consent, we studied the details of 50 women who had scar dehiscence (grade III or IV, partial or complete) reported at repeat caesarean section. We excluded cases with scar rupture with the fetus in the peritoneal cavity, more than one previous cesarean and chorioamnionitis. We analyzed the present and past pregnancy details, these women's clinical features and obstetric factors.</p> Results <p>Sixty-five out of the 4079 women with a previous caesarean had a scar event (1.6% dehiscence rate). We excluded nine women with fetal extrusion into the peritoneal cavity, three with chorioamnionitis and three with incomplete data. The mean age of the study population was 27&#xa0;years. Ten dehiscence were silent and reported at elective repeat cesarean section. Eleven women (22%) had induction of labor. Among the fifty women, only 11 (22%) had clinical symptoms or signs of dehiscence. Others had an emergency caesarean for failed induction/dystocia/abnormal fetal heart rate. None of the women had a perinatal loss, blood transfusion or hysterectomy.</p> Conclusion <p>Scar dehiscence in women with previous one cesarean is rare. Failed progress of labor, abnormal fetal heart pattern and silent asymptomatic are more common features than the classical signs and symptoms of dehiscence.</p>

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Clinical Presentation and Obstetric Profile of Uterine Scar Dehiscence (Grade iii/iv) Among Women with Previous One Caesarean Pregnancy

  • 期刊论文

  • 发表日期：

    2025年10月22日

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  • Gowri Dorairajan,
  • J. Yavanasurya,
  • Vignesh Durai,
  • V. Gladwin,
  • Nisha Yadav,
  • S. Nivedha

摘要

Objective

To understand the clinical presentation, obstetric profile, and outcome of scar dehiscence (grade III/IV scar) among women with a previous caesarean.

Methods

This study is a secondary analysis of an ICMR-funded project (June 2021 to July 2024). After obtaining the institute's ethical clearance and informed consent, we studied the details of 50 women who had scar dehiscence (grade III or IV, partial or complete) reported at repeat caesarean section. We excluded cases with scar rupture with the fetus in the peritoneal cavity, more than one previous cesarean and chorioamnionitis. We analyzed the present and past pregnancy details, these women's clinical features and obstetric factors.

Results

Sixty-five out of the 4079 women with a previous caesarean had a scar event (1.6% dehiscence rate). We excluded nine women with fetal extrusion into the peritoneal cavity, three with chorioamnionitis and three with incomplete data. The mean age of the study population was 27 years. Ten dehiscence were silent and reported at elective repeat cesarean section. Eleven women (22%) had induction of labor. Among the fifty women, only 11 (22%) had clinical symptoms or signs of dehiscence. Others had an emergency caesarean for failed induction/dystocia/abnormal fetal heart rate. None of the women had a perinatal loss, blood transfusion or hysterectomy.

Conclusion

Scar dehiscence in women with previous one cesarean is rare. Failed progress of labor, abnormal fetal heart pattern and silent asymptomatic are more common features than the classical signs and symptoms of dehiscence.