US for scar thickness? - Mothering Forums

 
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#1 of 14 Old 08-05-2009, 12:07 PM - Thread Starter
 
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I'm wondering if they can accurately see scar thickness and whatnot in the 20 week ultrasound. I know I have to have another at 36 weeks to check it, but I was thinking back and I'm a teensy bit worried...I started doing things before I shouldve, and ended up pulling something in there. I honestly think I pulled some of the internal stitches, it hurt soooo bad in these 2 spots for so long. When I brought it up at the OB's though, it was shrugged off.

So I'm a bit worried that if I DID pull some internal stitches, that my scar might not be normal in those areas. Do they just look at thickness or other things as well, such as symmetry? I dont want to be risked out at 36 weeks over it-if I'm going to be risked out, I'd rather it be earlier than later so I can find a new provider.

I've just gotten myself worried...I really dont want another C and if I messed up my scar, I'll feel horrible. I also wouldnt know if it was truely unsafe for me to attempt a VBAC or not. Blarg.

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#2 of 14 Old 08-05-2009, 06:04 PM
 
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I'm sorry it's so worrying! Having been sectioned sucks!

As to scar thickness, I'm under the impression that the thickness or thinness is not altogether indicative of the chances of rupture. I think it's just another way to risk you out unnecessarily. Don't know anything about whether they will be able to tell how the scar healed. I hope someone with actual INFO will reply!

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#3 of 14 Old 08-06-2009, 07:14 AM
 
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I'm not sure I'd even mention it. Luckily my OB only glanced at my scar b/c I asked if he could see it via u/s. My dearly departed OB told me that scar thickness does NOT figure into rupture risk. There's really just no way to tell if a scar is going to give or not. Assuming that you had double-layer suturing with your previous c/s, just work on trusting that your body knows how to heal and that your uterus will be strong.

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#4 of 14 Old 08-06-2009, 09:34 AM
 
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Yeah, even my crazy, interventionist OB didn't think measuring scar thickness meant anything. The way he described it to me is that, at term, the whole uterus is pretty darn thin, so a thin scar is par for the course.

I asked my aunt (who did my u/s during pregnancy) about it and she said if you even look at it, there is no point until right around the due date since there is so much stretching still to be done.

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#5 of 14 Old 08-06-2009, 01:49 PM
 
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I have never had that done and most of the time no U/S at all, 7 successful HBAC.
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#6 of 14 Old 08-06-2009, 05:59 PM
 
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I've had 2 VBACs with single-layer uterine closure and my OB's have NEVER looked at scar thickness via US. I'm a L&D nurse and actually have never heard of doing that EVER! I don't think it would be an accurate way of judging who would rupture.

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#7 of 14 Old 08-08-2009, 06:48 PM
 
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There are several studies that explore u/s measurement of scar thickness as a possible indicator of UR risk. What the studies have found is that a "thin scar" does seem to relate to an increase in UR risk but a "thick scar" doesn't necessarily mean a reduction in UR risk (and even with a "thin scar" the increased risk isn't huge). And these are scans being taken very late in pregnancy when the uterus is well stretched... I'm pretty sure a scar measurement taken at 20 weeks wouldn't tell you much at all unless there was something really significant happening.

So basically, while a late pregnancy u/s of your scar might give you some information it certainly shouldn't be a major factor in anyone's VBAC vs rC/S decision.


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#8 of 14 Old 08-10-2009, 12:19 PM
 
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I did read the study as I was concerned too. The difference was less than a millimeter and mostly inaccurate.

the likelyhood is only .02% with the scar
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#9 of 14 Old 08-11-2009, 12:30 AM
 
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Quote:
Originally Posted by Lisoula View Post
I've had 2 VBACs with single-layer uterine closure and my OB's have NEVER looked at scar thickness via US. I'm a L&D nurse and actually have never heard of doing that EVER! I don't think it would be an accurate way of judging who would rupture.
That's terrific!

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#10 of 14 Old 08-11-2009, 11:08 PM - Thread Starter
 
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Sorry I havent been back to check this in a bit. Anywho, its my homebirth midwife who is required by the state to do a uterine scar thickness US at 36 weeks. If the US tech or the doc say its not good, then I'm risked out and have to transfer to OB care.

In any case, at this point, I'm probably doing a UC anyway, so it wont matter. We thought we *might* be able to come up with enough money for the midwife fee (medicaid doesnt cover the birth of a VBAC, so nice), but we discovered that the little bit of money we thought we would have, we wont. So...I'm probably UCing, which my fiance is fine with and keeps the pressure off from being risked out anyway :P

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#11 of 14 Old 08-12-2009, 12:42 PM
 
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Good luck w/ your UC plans!
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#12 of 14 Old 08-13-2009, 01:39 AM - Thread Starter
 
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Thanks!

I think I'm scaring myself by trying to be prepared and reading rupture stories. My mind is like omg, maybe I should go to the hospital and be monitored and whatnot...but then realistically, I wouldnt be able to be continuously monitored and still be able to handle labor, which would mean an epidural, which would possibly lead to other interventions and the inability to feel a UR.

I need to quit reading so much.

I am however thinking of renting a hotel room near the hospital. I dunno...I'm maybe 10 minutes, maybe more depending on lights, to the hospital. I know in a UR case thats a long time. What would you do? I dont think I *will* rupture, but then again, I do want to be prepared. Blarg! Decisions are hard!

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#13 of 14 Old 08-13-2009, 08:25 AM
 
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Cari, you can always make the choice to go into the hospital.

And I probably wouldn't want to labor in a hotel unless I was far away from the hospital. But you should plan on laboring and birthing where YOU will feel the most comfortable - if that's a hotel, great; if that's home, great.

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#14 of 14 Old 08-13-2009, 03:03 PM - Thread Starter
 
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Yeah, someone on the UC board reminded me too that the rate of rupture includes statistics from minor ruptures and I think it includes windowing too...so I'm calm again.

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