Reducing Your Chances of Uterine Rupture
New Test Measures the Thickness of Previous Cesarean Scar
Mar 1, 2009
There are many ways to increase your chances of having a successful VBAC such as choosing a VBAC- friendly place of birth and care provider. There are also numerous ways to avoid having a cesarean including being upright during labor and avoiding an early epidural. However until now, there has not been a test to determine if the mother is at greater or lesser risk of having a uterine rupture.
One of the biggest risks for a mother who has had a previous cesarean is that the scar tissue in her uterus will open during the subsequent labor, otherwise known as a uterine rupture. Though very rare (1% risk), uterine rupture can cause devastating injuries to both mother and baby. For that reason, fewer care providers and even some hospitals are refusing to allow mothers to have a VBAC.
New research in Canada indicates that a test could determine the possible risks of uterine rupture even before the mother starts labor.
Test for Uterine Scar Thickness
According to research performed at the University of Laval in Quebec, taking a measurement of the thickness of the scar may be an indicator of the strength or weakness of the scar tissue and how susceptible it may be to rupture. A total of 236 women with a previous cesarean, who were planning a VBAC, were followed during their pregnancy. Researchers used ultrasound as a tool to measure the thickness of the lower segment of the uterus. The number of mothers who had a uterine rupture during labor were 3 out of 236.
The Thicker the Uterine Scar, the Stronger the Tissue, The Smaller the Risk of Uterine Rupture
As a result of this study, researchers concluded that all of the mothers who had a uterine rupture had a very thin scar. According to the results, the cut-off was found to be 2.3 millimeters. If the mothers had a scar smaller than 2.0 mm, her chances of uterine rupture was about 10%, versus the typical risk of 1%.
This new information can be helpful to a mother planning a VBAC as she consults with her own primary provider. This test is not done routinely in the US, however it is being offered in other regions of the world such as Canada.
If you are interested in having a VBAC, check with your obstetrician, family practice physician or nurse midwife about the availability of this ultrasound test in your region.
 |
