ASSOCIATION BETWEEN PREOPERATIVE SCAR TENDERNESS AND PEROPERATIVE WOUND DEHISCENCE IN PATIENTS WITH PREVIOUS C-SECTION

Abstract

Background: Growing rates of caesarean sections (CS) have led to an increase in the observation of uterine scar dehiscence and scar pain. Despite the consequences for maternal and fetal outcomes, their clinical relationship is still little understood in South Asian populations.

Objectives: To determine important predictors of wound disintegration in women with a history of CS and to assess the association between preoperative scars tenderness and perioperative wound dehiscence.
Methods: 360 pregnant women with a history of caesarean sections were randomly assigned to tenderness or non-tenderness groups in a prospective case-control research study at CMH Gujranwala from 25 March 2025 till 25 June 2025. Clinical and demographic information was gathered. Data were analyzed using logistic regression, chi-square testing, and Mann-Whitney U tests after an intraoperative scar assessment.

Results: 39.2% of subjects showed signs of wound dehiscence. Dehiscence and parity, anemia, hypertension, booking status, prior CS count, and lifestyle were found to be significantly correlated (p < 0.001). Women with dehiscence had significantly higher gestational age, BMI, and age, according to the Mann-Whitney U test (p < 0.001). Anemia (OR = 0.251, 95% CI: 0.10–0.64, p = 0.004), scar tenderness (OR = 0.008, 95% CI: 0.001–0.08, p < 0.001), and a sedentary lifestyle (OR = 0.134, 95% CI: 0.05–0.37, p < 0.001) were found to be protective factors by logistic regression. Conversely, increasing maternal age (OR = 1.287, p = 0.047) and BMI (OR = 1.751, p = 0.015) were independent risk factors.

Conclusion: The probability of wound dehiscence is greatly influenced by lifestyle variables, anemia, and scar tenderness. Prediction and surgical results in repeat CS cases may be enhanced by incorporating these criteria during prenatal evaluation.