Jen

I don’t think there is sufficient evidence to support measuring uterine/scar thickness as a method to predict uterine rupture.

I think it’s important to consider what you will do with the information. If they tell you that it’s “to thin,” how will you proceed? Will you ask for the measurement? Will you cross reference it against the studies listed above? Because see, they are not large enough to measure uterine rupture. We need about 5,000 women in a study in order to do that and our largest study above is 642 women.

I personally think that uterine thickness is used as a way to a) cover the bottoms of practitioners if you do rupture as a way of showing they did all they could to “inform” you and b) to dissuade women from pursuing a VBAC by planting the seeds of doubt.

Ultimately, you have to decide what makes since to you.

Warmly,

Jen

I just had my LUS measured today and I’m not sure if the measurement I was given is accurate. The technician doing the ultra-sound couldn’t find the scar and when she finally did she said she needed to confirm it with a radiologist first because she wasn’t sure if she was measuring the right thing. Her original measurement was 17mm but the radiologist then confirmed she had indeed found the scar but that her measurement was wrong, its 7mm. What do I do? Should I request a repeat ultra-sound as I’m not sure any of them know what they are talking about?

I don’t put much stock in measuring uterine thickness because the studies do not include enough women to accurately detect uterine rupture. We need about 5,000 women with prior cesareans for that and our largest study here includes 642 – not nearly enough.

Hopefully these studies will be replicated using more women, but until then, I would not get my uterus measured.

Warmly,

Jen

In order to accurately measure uterine rupture (which happens about 0.4% of the time during spontaneous trial of labors after one prior low transverse cesarean) (Landon 2004), a study needs about 5,000 women participating.

All of these studies have far less women which is why there is not a whole lot of support for measuring uterine thickness in women seeking VBAC nor is it a technique commonly used.

In the first study (Rozenberg 1996), we had 642 women which means it’s not sensitive enough to provide us with an accurate rate of uterine rupture. Often what happens in smaller studies like this is you either get a really high number, as Rozenberg did, or a really low number.

I hope that these studies will be replicated using thousands of women. I think the idea is interesting and it might prove to be a good tool. However I think that we currently have insufficient evidence to support the practice of measuring uterine thickness. I personally wouldn’t do it.

Warmly,

Jen

I am also very curious about Study #1. Is there any reason why the rate of rupture was so extraordinarily high in this sample? The rate overall was 4% – more than 8 times the usual rate. Like WTF??

I’m so sorry for all you have been through. I do not know the safe/normal thickness of a unpregnant uterus nor do I know why this might be occurring to you.

I recommend getting a copy of your medical records and obtaining a second opinion from a VBAC supportive provider. Read Item #3 of this article http://vbacfacts.com/2009/01/15/im-pregnant-and-want-a-vbac-what-do-i-do/ where I link to several articles regarding finding and interviewing care providers.

I’m hoping another reader will be able to offer some insight in the meantime.

Warmly,

Jen

It is now 3 and half years later, that I have just discovered via ultrasound investgation that I have a thinning of the uterus on my right hand side where my caesar scar is. My G.P started investigations as I hadn’t fallen pregnant again, despite years of trying. I am in shock and devastation and in the “unknown” as to whether I will be able to have another child, let alone a vaginal birth. I have only seen my G.P at this stage and could be waiting a long period to see my Gyno for an accurate opinion.(Unless you live in a major city in Australia you don’t have a lot of doctors available to you).

I don’t know the thickness of the thinning site, as my ultrasound doesn’t mention the measurememnt.

I apologise for the rambling story, but I just had to purge my story, as I sift through internet information trying to find an answer to my dilemma. Can anyone tell me why this happens? And at what point is it downright dangerous to fall pregnant…what thickness will be the absolute minimum. At the end of the day I want to be around for my son, not risking my life and another babies.

My name is Carrie. Could you PLEASE send me an email of the scan you had done. I recently had it done and want to see if my doctor did it correctly. I do not think so since I am 20 weeks and they had me empty my bladder. I am having it done again at 32 weeks and it looks like by your post I should wait until I am 36 weeks. I am also confused because the peri told me that my scar meassured 6.5 all the way across except in one area and he said it was 1.7 however, I do not think they did the test correctly at all. I would so greatful if you would email me the pictures of your scan!!

Thank you,

Carrie