|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: Ultrasound measuments of LUS to evaluate the risk of uterine ruptureFrom: Elenita L. Mojica-Veloso (lenvelosomd@yahoo.com)Sun Feb 8 17:11:46 2009
. in the At Sun, 24 Feb 2002, dracheng@yahoo.com wrote: > >At Wed, 3 Jan 2001, Sabina Norderhaug wrote: >> >>>From what I know, 1 cm is quite a thick uterus and there are very few >>women after caserean who will have such a thick LUS before the delivery. >>May be you are talking about some certain measuring technique? Is this >>number based on your own experience? Can you please explain more? >> >>According to Patrick Rozenberg and others' study for transabdominal >>measurements: >> >>FINDINGS: The overall frequency of defective scars was 4.0% (15 uterine >>ruptures and 10 dehiscences). The frequency of defects rose as the >>thickness of the lower uterine segment decreased: there were no defects >>among 278 women with measurements greater than 4.5 mm, three (2%) among >>177 patients with values of 3.6-4.5 mm, 14 (10%) among 136 patients with >>values of 2.6-3.5 mm, and eight (16%) among 51 women with values of >>1.6-2.5 mm. With a cut-off value of 3.5 mm, the sensitivity of >>ultrasonographic measurement was 88.0%, the specificity 73.2%, positive >>predictive value 11.8%, and negative predictive value 99.3%. >>INTERPRETATION: Our results show that the risk of a defective scar is >>directly correlated to the degree of thinning of the lower uterine >>segment at around 37 weeks of pregnancy. The high negative predictive >>value of the method may encourage obstetricians in hospitals where >>routine repeat elective cesarean is the standard procedure to offer a >>trial of labor to patients with a thickness value of 3.5 mm or greater. >> >>According to Asakura and others' study for transvaginal measurements of >>muscular layer only: >> >>Conclusion: Measurement of the lower uterine segment is useful in >>predicting the absence of dehiscence among gravidas with previous >>cesarean section. If the thickness of the lower uterine segment is more >>than 1.6 mm, the possibility of dehiscence during the subsequent trials >>of labor is very small. >> >>Sabina >> >>At Thu, 04 Jan 2001, Dr. Fazeel-uz-Zaman wrote: >>> >>>--------------7B8F6A2709897892ECC148E0 >>>Content-Type: text/plain; charset=us-ascii >>>Content-Transfer-Encoding: 7bit >>> >>>I guess if the scar thickness is less than 1 cms, there is risk og rupture. >>>Fazeel >>>I am presently a resident of the Department of Obstetrics and Gynecology at Capitol Medical CEnter, Philippines. I am very interested in doing a research on the thickness of the lower uterine segment in previously sectioned women who would like to undergo trial of labor. I would like to request for copies of journals or previous studies done on this topic. Our department is advocating VDAC (vaginal delivery after a ceasarian), and with this would like to reiterate the possibility of such by doing this research paper. would like to thank you in advance for a favorable response to my request.
-- I am interested in the succeeding pregnancy outcome of women whose ruptured uteri were repaired.
|
|
Return to
|
Mail a New Message to the Forum: ultrasound@obgyn.net Forum Administrator: terry.dubose@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Mon Nov 2 05:37:46 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.