Sonography of lower uterine segment thickness and prediction of uterine rupture.
BACKGROUND
Sonographic evaluation of the lower uterine segment was undertaken to study the degree of thinning and, thus, to predict uterine rupture. However, the best measuring technique and recommended cutoff values remain controversial.


METHODS
Sonographic evaluation of the lower uterine segment at 36 weeks of gestation in a 31-year-old patient with prior low transverse cesarean delivery revealed a full thickness of 3.6 mm and a myometrial layer of 1.1 mm. Nevertheless, the patient experienced a large uterine rupture during a trial of labor at term.


CONCLUSIONS
In this case, there was a discrepancy between the full thickness and the myometrial layer, which could be representative of the lower uterine segment resistance. Such a case emphasizes the need for a consensus on sonographic measuring techniques for the prediction of uterine rupture.
Bergeron
Marie-Ève
MÈ
From the Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Centre de recherche, Centre Hospitalier Universitaire de Québec, Québec, QC, Canada; and the Department of Obstetrics and Gynecology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.
Jastrow
Nicole
N
Brassard
Normand
N
Paris
Gaétan
G
Bujold
Emmanuel
E
D000328:Adult; D017604:Cesarean Section, Repeat; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006465:Hemoperitoneum / Q000209:etiology; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects; D009215:Myometrium / Q000000981:diagnostic imaging* / Q000473:pathology; D011247:Pregnancy; D014219:Trial of Labor; D014463:Ultrasonography; D014597:Uterine Rupture / Q000000981:diagnostic imaging / Q000209:etiology*; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects*