Scar thickness?

cjpreuss

I may be going crazy.... but I swear I read somewhere that there is a way to ultrasound and tell the thickness of your c-section scar on your ute. Am I just nuts or has someone else heard of this? Before I bring it up to a medical professional I'd like to know that I'm not totally making it up... which I probably am. LOL

Brownie_222

Yes, but as I recall it doesn't accurately forecast rupture risk - so I don't think it is routinely done.  Iris probably has a link to share or a more complete answer.

iris427

Brownie_222:

Yes, but as I recall it doesn't accurately forecast rupture risk - so I don't think it is routinely done.  Iris probably has a link to share or a more complete answer.

Yep.  There is no established guideline for how thick it should be in order for VBAC to be safe, or way to use scar thickness to predict uterine rupture.  Here is a summary of this from Up To Date:

Use of imaging to predict risk of uterine rupture ? Imaging techniques have been used in an attempt to predict women at increased risk of uterine rupture, with mixed results. The most common technique is ultrasound measurement of the thickness of the lower uterine segment in the third trimester. A systematic review of 12 studies of sonographic lower uterine segment thickness for predicting the risk of uterine scar defect rupture could not determine an ideal cut-off [57]. The optimal cut-off value varied from 2.0 to 3.5 mm for full lower uterine segment thickness (smallest measurement between the amniotic fluid and urine in the maternal bladder) and from 1.4 to 2.0 mm for thickness of the myometrial layer (smallest measurement of the hypoechoic portion of the lower uterine segment). When the lower uterine segment thickness was thin, the pooled odds ratio of uterine rupture was 11.2 (95% CI 6.5-19.4); when the myometrial thickness was thin, the pooled odds ratio of uterine rupture was 5.2 (95% CI 2.5-10.8). At least one case report has described a catastrophic uterine rupture with complete extrusion of fetus and placenta and neonatal acidosis in a woman whose sonographic lower uterine segment measurement exceeded 3.5 mm [58]. Thus, there is no clinically useful ultrasonic measurement of the lower uterine segment in late pregnancy that is 100 percent predictive or protective of catastrophic uterine disruption.

https://www.uptodate.com/contents/choosing-the-route-of-delivery-after-cesarean-birth

There is no reliable way to predict who will have a rupture.  Fortunately UR is rare and most will have good outcomes.

court1703

Just had my A/S and I asked the ultra sound tech if she could see it.  She pointed it out and said it looked good.  I'm guessing they should probably be able to measure it.  What that would tell you I don't know.

treble_clef

Yes.  I'm seeing perinatologist this time because I had preterm labor with my son.  He was a breech baby, so I had a c-section, and every time I have an ultrasound, they check my uterine synechiae.  They said it's not affecting the pregnancy, and I'll be able to try a VBAC.  So far they've been paying more attention to the synechiae than preterm labor.  It worried me a bit at first because no one mentioned about it before.  I'm glad the placenta is not covering it, and my baby is healthy:)