Sonographic Detection of Uterine Dehiscence - Essay Example

The chief consideration for sonographers is placental abruption, ectopic pregnancy, and perhaps extra uterine causes. Some of the symptoms of uterine dehiscence may include pain or vaginal bleeding and its significance is linked with the possibility of a complete uterine rapture with the labour onset (Youngs, Praska, and Harms, 418-421).

This article is satisfactory, especially in the way the authors have analyzed their subject. A case study was carried out and well documented in the article. Apart from describing uterine dehiscence is described as an incomplete separation of the myometrium at a uterine scar site there is also another danger imposed by complete uterine rupture, which is caused by labour contractions. The authors of this article have also referred to different previous knowledge such s Asakura et al. and Gotoh et al who gave their opinions about the sonographic relationship between the thickness of the uterine wall and uterine rapture. Complete uterine rupture is linked with uterine dehiscence. This article asserts that there is a vital need of reducing maternal and fetal compromise by carrying out the sonographic diagnosis of uterine dehiscence (Youngs, Praska, and Harms, 418-421).

A woman in her 20s with gravida 2 and para 1 in the 26 weeks of gestation period was used. She had a cute pain from her umbilicus although no vaginal bleeding or even loss of fluid. Also, the woman had undergone cesarean section previously and a sonographic examination was performed by Philips/ATL HDI 5000 sonography system of the 5-MHz curvilinear transducer and later admitted to Labor and Delivery for observation. Another obstetric sonographic examination intended to evaluate the appendix was carried out using Siemens/Sequoia sonography system whose curvilinear transducer was 6-MHz and finally Tocolysis. The authors analyzed this study after thorough medical procedures were employed in carrying out the study (Youngs, Praska, and Harms, 418-421).

It has been found that women with prior caesarian delivery history and experienced trials of labour are likely to suffer from uterine dehiscence and rupture. Complete uterine rapture is very risky and may even lead to hysterectomy, haemorrhage, or even sock for the mother. There are also cases of dehiscence and rapture during the antepartum period although it has not been linked with serious maternal as well as perinatal morbidity. It is however worth noting that incomplete rapture may see the split of urine contents from the peritoneal cavity particularly by the visceral peritoneum of the uterus. Any form of evidence regarding uterine dehiscence should be sought as soon as possible due to the dangers associated with it (Youngs, Praska, and Harms, 418-421).

Out of the six viewed reports of prenatal sonographic detection of uterine dehiscence five indicated acute localized pain without vaginal bleeding but one showed blood-tinged vaginal discharge on the patient. Additionally, all the cases validated sonographic evidence of membranes protruding via uterine scar defect but Bromley described any exception to this in unusual cases. Also, it was found that the probability of rapture is high when the myometrium thickness is 3.5mm or even less or almost 37 weeks of gestation. Sonographers may use their evidence in counselling patients with previous caesarian sections concerning the trial of labour and evaluation of intrauterine gestation more so during abdominal pain. In case of any suspicion about uterine dehiscence, there may be several serial assessments done to confirm the challenge (Youngs, Praska, and Harms, 418-421).

The population was not adequate to prove the credibility of the study. The study was conducted by a woman in her late 20s with gravida 2 and para 1which was presented at 26 weeks of gestation. The fact that the woman was complaining of acute pain from the umbilicus to the groin with the absence of vaginal bleeding, loss of fluid and past uncomplicated cesarean section sometimes back was an important aspect in this study. This could give enough evidence and credibility to the study though not to a higher extent because the population involved in the study was not sufficient (Youngs, Praska, and Harms, 418-421). However, the different sonographic examinations may play an important role in boosting confidentiality in the study. Read More