Accuracy of Two Dimensional and Three dimensional trans-abdominal Ultrasound in Prediction of CS Scar Dehiscence Before Delivery

Background: Caesarean delivery rates have been rising over the past two decades. These rates continue to evoke worldwide concern because of their steady increase. Aim and objectives: To assess the accuracy of two-dimensional(2D) and three-dimensional(3D) trans-abdominal ultrasonography(TAS) in the prediction of caesarean section(CS) scar dehiscence before delivery and to compare the outcome of measurement with the intraoperative visual assessment of the scar. Subjects and methods: This prospective study was conducted on 145 patients with a gestational age(GA) of>37weeks, at the department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, from October 2023 till October 2024. Results: There was no statistically significant difference between LUS 3D vs LUS 2D, while there was statistically significant difference between three groups. There was no statistically significant difference between the studied groups regarding 2Ds(mm) (mid Sagittal plane), 2Ds(mm) (lateral plane) while, there was Highly statistically significant difference between the studied groups regarding 3Ds(mm). Conclusion: Both 2D and 3D transabdominal ultrasonography were effective, safe methods for the prediction of CS scar dehiscence. Moreover, level of accuracy of 3D was higher than 2D, by comparing the area under the curve(AUC) for the receiver operator characteristic curve(ROC), it was showed that the 3D had sensitivity of 98% and 70% specificity with highly significance for predicting uterine scar, 2D had sensitivity of 62.5% and 77% specificity with no significance for predicting uterine scar. These results emphasized that (3D) trans-abdominal ultrasonography was the most reliable and accurate predictor for uterine scar dehiscence.