 Good morning everyone, I will be presenting a paper on the evaluation of lower uterine segment thickness biotrason. Coming to the introduction part, C-section rates are rising throughout the world. Most of the women with previous one C-section would prefer to undergo trial of vaginal work. Uterine scar decency is an important complication associated with previous LSEs in which there is disruption and separation of previous care. The incidence reported for uterine scar decency is between 0.2413% of all pregnancies associated with previous C-section. Pre-repair diagnosis of uterine decency will allow decision regarding trial of labour. A successful vaginal birth after C-section is associated with clear complication than an electro-repleted C-section. Ultrasonography can be used to check the integrity of previous scar and it can be helpful in predicting uterine ruptured during labour by calculating the lower uterine segment scar thickness. Coming to the aim of the study, it is to assess the utility of ultrasound in determining the scar thickness in previous C-section to plan for trial of labour after C-section. Coming to the methodology part, it is a prospective observational study done over a period of 6 months. It was done at Fadambulla Medical College Hospital upon ethical approval. A total of 62 pregnant women who had history of at least one previous LSEs admitted to Fadambulla Medical College Hospital were recruited. With the inclusion criteria, patient with history of previous one LSEs had single-term pregnancy with term pregnancy with cephalin presentation were included for the study. Exclusion criteria with patients with multiple gestation, previous normal vaginal delivery, placenta-previa, polyhedronius or oligodronius. For the plan of the study, 62 cases were included in the study. History and thorough examination of all these patients were done. Age of static score, time interval between previous LSEs and subsequent conception, number of LSEs were noted. Cetaphysical examination and obstetrics examination were done in these patients and scarred at theness was noted. The lower uterine segment scar thickness was assessed by single-summonage weight transseptominal ultrasonography on Philips Affinity 70 with the partially full bladder after taking infant consent. Ultrason was done 24 hours prior to undergoing elective LSEs on in cases of emergency LSEs prior to the surgery without contractions. The lower uterine segment was assessed both in longitudinal and transverse plane under magnification to find out weakened area or rupture. At least two measurements were recorded and the lowest measurement was taken. These sonographic findings were compared with the interoperative lower uterine segment appearance. Degree surgery before extraction, visual inspection of the scar was done. Then after the extraction of the baby, the thickness of the lower segment was measured using a sterile disposable measuring scale. The lower uterine segment scar was graded as one of the following, that is normal thinned out dacens or ruptured. All the given data were entered on statistical package for social science version 23. The statistical significance was set at a P value of equal to less than 0.05. Here the graph shows the maximum participants were in the age group of 0.5 to 30 years and minimum being 31 to 35 years. Here in this graph it shows that the maximum participants underwent LSEs at the gestation age between 37 to 40 weeks while one of the participants has underwent LSEs at 32 weeks period of gestation in view of IUGF. The above table shows that the mean age of the participant was at 7 years. The mean gestation age was bound to be 37 years. The mean entrepreneur's interval was 4 years. The mean ultrasound scar thickness was 0.4 cm and interrupts scar thickness of 0.42 cm with the P value of 0.005 which is statistically significant. This graph shows that the maximum ultrasound thickness of scar raised from 0.30 to 0.4 cm while the minimum being 0.7 to 0.9 cm. This graph shows that the maximum scar thickness noted interrupt between 0.3 to 0.4 cm. This graph compares the scar thickness measured by the ultrasound and the interrupt. This graph compares the interdependency interval with that of the interrupt scar thickness. It shows that participants who had 1 to 2 years and 6 to 7 years of interdependence interval had scar thickness of 0.8 cm while with lowest scar thickness was 0.26 cm and had interdependency interval of 4 to 5 years. Coming to the discussion part in this study, Sonographic and Interoperative Analysis showed that the P value is 0.005 which is statistically significant. Studies have suggested that there is inverse relation between scar thickness as such sonographically and riscopiotaic also. So, other studies where Suzuki et al, Foucault et al and Rosenberg et al also used the transseptominal ultrasound versus previous scar. While Guthe et al used transveginal ultrasound versus the lower uterine segments scar. Their conclusions were similar to our study. You know, Kustaki et al suggested that lower uterine segment thickness of at least 3 mm measured by abdominal ultrasound monography before delivery and term in movement with previous C-section is suggestive of stronger lower uterine segment but is not a reliable shortcut for trial employment. Abish kind colleagues showed that KVS provided more accurate information about the condition of the scar lower uterine segment than MLN. The main factors that limited the increased use of KVS for assessment of lower uterine segment thickness are discomfort and difficulty in performing the procedure in movement. Coming to the conclusion, term ultrasound scan by transseptominal or transveginal scan can be recommended for assessment of scar thickness before planning for trial of labor after C-section. Thank you. These are my references.