摘要
目的:分析经腹超声诊断孕中晚期子宫瘢痕前壁下段厚度对分娩方式及子宫破裂发生情况的预测价值。方法:选择2015年11月至2017年8月我院分娩的有剖宫产史的再次妊娠的孕中晚期妇女92例,采用经腹超声观察子宫下段的厚度及结构,根据图像及前壁下段厚度将受试者按瘢痕等级分为Ⅰ级瘢痕组(共44例)、Ⅱ级瘢痕组(共25例)和Ⅲ级瘢痕组(共23例),比较3组随孕周变化的前壁下段厚度变化情况及妊娠结局。结果:随着孕周数的增加Ⅰ级瘢痕组子宫前壁下段厚度明显高于Ⅱ级瘢痕组、Ⅲ级瘢痕组(P<0.05),3组子宫前壁下段厚度均明显变薄,组内不同孕周比较差异均具有统计学意义(P<0.05);随着瘢痕等级的增加,阴道试产成功率逐渐下降,先兆子宫破裂发生率明显升高,组间比较差异均具有统计学意义(P<0.05)。结论:经腹超声能显示妊娠中晚期子宫下段肌层情况及子宫瘢痕前壁下段厚度,为临床阴道试产及先兆子宫破裂提供有价值的诊断信息。
Objective： To analyze the predictive value of transabdominal ultrasonography in the diagnosis of the thickness of lower segment of the anterior wall of the uterine scar in the middle and late stage of pregnancy on the way of delivery and the occurrence of uterine rupture. Method： Chose 92 cases of pregnant women with cesarean section at the second trimester or at the third trimester who gave birth in our hospital between November 2015 and August 2017. Used abdominal ultrasound to observe the thickness and structure of the lower uterine segment. According to the image and the thickness of lower segment of the anterior wall, the subjects would be divided into grade Ⅰ scar group（44 cases）, grade Ⅱ scar group（25 cases） and grade Ⅲ scar group（23 cases）. Compared the changes in the thickness of lower segment of the anterior wall varying with gestational age and the outcome of pregnancy of the three groups. Results： With the increase of pregnant weeks, the thickness of lower segment the uterine anterior wall of the grade Ⅰ scar group was obviously higher than that of the grade Ⅱ scar group and the grade Ⅲ scar group（P〈0.05）. The thickness of the lower segment of uterine anterior wall in the three groups was significantly thinner, and there were statistically significant differences in the different gestational weeks（P〈0.05）. With the increase of scar grade, the success rate of vaginal trial production decreased gradually, and the incidence of threatened uterine rupture was significantly increased. Moreover, there was statistically significant difference between groups（P〈0.05）. Conclusion： Transabdominal ultrasonography can show the muscularis of the lower uterine segment and the thickness of the lower segment of anterior wall of the uterine scar at the second and third trimester. Therefore, it can be used to provide valuable diagnostic information for the clinical vaginal trial production and the threatened uterine rupture.
作者
成映富
谢群
洪小丽
卢红
徐晓英
CHEN Ying-fu;XIE Qun;HONG Xiao-li;LU Hong;XU Xiao-ying(Department of Ultrasound,Haian Hospital,Affiliated Hospital of Nantong University,Nantong 226600,China)
出处
《CT理论与应用研究（中英文）》
2018年第4期499-504,共6页
Computerized Tomography Theory and Applications
基金
南通市科技计划指导性项目(GJZ17109)
关键词
超声
子宫瘢痕
前壁下段
ultrasound
uterine scar
lower segment of the anterior wall
