Re: Scanning the lower UT segment post prior C-section to evaluate VBAC

From: art fougner, md (evsono@pipeline.com)
Mon Oct 27 06:42:26 2003


Rich

the best time to evaluate the healing lower segment is prior to the next pregnancy. Using TVS, a wedge - shaped defect in the area of the Cesarean incision suggests a potential problem. This finding, however, has not been subjected to randomized trial of VBAC to evaluate its predictive value for uterine rupture.

art

At Sun, 26 Oct 2003, Rich Dempsey RDMS/RVT wrote: >
>Does anyone have experience evaluating evaluate the lower uterine
>segment (myometrial thickness) over a C-section scar ? The circumstances
>involved a near term pregnancy with a prior C-section. The physician
>wanted to know if there was thinning of the myometrium in the LUS, prior
>to deciding on trial vaginal delivery; that is, an attempt to judge the
>risk of uterine dehiscence prior to committing to trial labor).
>
>There are a number of articles in the non-American OB literature on the
>topic , and nothing in the Radiology literature. The OB literature
>reports a full-thickness measure (via transabdominal scanning) of >3.5
>mm as having high negative predictive value.
>
>Does any one have experience with this?

--
art fougner, md
ich bin ein New Yorker



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