[rainbowfairymomma]

Hi mama's
I recently read somewhere that measruing the thickness of a c/s scar can help determine if you have a higher risk of rupture or not. This is best done after 37 weels. Anyone heard of this? Anyone done this? How accurate is this information?
Thanks

 

[tuffykenwell]

I am not sure how they would measure the scar on your uterus. Can it be seen with an x-ray (but then again you wouldn't do that when you are pregnant....)...I don't think they can see it with an u/s so I am not sure how it could be measured (but I might just be missing something LOL).

The scar on your belly doesn't mean anything. You could have a big ugly huge scar on your belly and a teeny beautifully healed scar on your uterus...or vice versa so looking at the one doesn't give you any indication of the state of the other.

Steph

 

[GoBecGo]

I have read about it but have no experience. From the studies i have read the problem seems to be in deciding how thick is thick enough. Some studiesfound 3.6mm to present the least risk but i read at least one which found no rupture or dishience in women with >1.7mm.

So while it might help me evaluate where to have my VBAC (i am a homebirther, so assuming i had a medical emergency, a transfer and a section for emergency, and then was planning my next birth a scan might make me opt for a hospital VBAC over a HBAC ifmy scar was thinner than one might hope) but it wouldn't put me off trying for one unless i already had dishience at 37 weeks.

ETA - they can measure it with ultrasound.

 

[egoldber]

Sorry, me again.

I had this done with the pregnancy after my rupture. I was considered very high risk and part of the management by my high risk specialist included a high resolution ultrasound of my uterus in the scar area at 32 weeks. The way the specialist explained it, while there are no guarantees, if the scar measures thick, you are much less likely to rupture than if it measures thin. I forget what the exact cutoff measurement was....perhaps 4mm?

In my case, since I had already ruptured in a previous pregnancy, they were extremely concerned when my scar was "immeasurably thin" at 32 weeks. I could clearly see for myself the area that the specialist was concerned about on the ultrasound. I was put on bedrest and my c-section was moved from 36 to 34 weeks. During the surgery, my OB clearly saw a large window on my uterus where the thin area appeared on the ultrasound.

So from my anecdotal experience, a thin measurement really did correspond to a thin area. Would I have ruptured again, well no way to know, but we were not willing to risk it.

 

[wombatclay]

Yup, it's a targeted u/s scan... the studies suggest that a thicker scar is less likely to open, but the studies can't say much about thinner scars. So it can be a good piece of information, but it doesn't give you the sort of "yes/no" information that would be ideal.

If UR is a specific concern (like in the case of a previous rupture, or a VBAmC) or if you are trying to decide betweeen different birth locations (home vs hospital) then the info might be really helpful. If, on the other hand, you don't have a specific concern and you'd be paying out of pocket for the scan then it may not be worth it.