论文部分内容阅读
目的:探讨经腹联合经会阴超声检测子宫下段瘢痕愈合情况及在再次妊娠分娩方式选择中的应用价值。方法:选取住院有剖宫产史的妊娠晚期孕妇150例(研究组),无剖宫产史的妊娠晚期孕妇50例(对照组),行腹部超声检查及联合阴道超声检查,比较子宫下段厚度及妊娠结局。结果:腹部联合阴道超声检查子宫下段显影率为100.00%,高于单纯腹部超声检查时显影率88.67%(P<0.05),联合检查较单纯腹部超声检查瘢痕分级诊断符合率高(P<0.05);研究组孕妇随着子宫下段瘢痕分级增加厚度变薄,不同分级瘢痕孕妇子宫下段厚度比较差异有统计学意义(P<0.05),研究组孕妇瘢痕分级Ⅱ级、Ⅲ级、Ⅳ级瘢痕子宫下段瘢痕厚度明显低于对照组(P<0.05);剖宫产率及产后出血量Ⅱ级、Ⅲ级、Ⅳ级瘢痕孕妇明显高于I级瘢痕及对照组(P<0.05),剖宫产术中出血量随着瘢痕分级增加明显增加(P<0.05),其中Ⅱ级、Ⅲ级、Ⅳ级瘢痕孕妇剖宫产率及术中出血量明显高于I级瘢痕及对照组出血量(P<0.05)。结论:经腹联合经阴道超声检查能提高子宫瘢痕检查诊断符合率,了解疤痕愈合情况以指导分娩方式的选择。
Objective: To investigate the application of transabdominal combined with ultrasound in the detection of lower uterine scar healing and the choice of pregnancy mode of delivery. Methods: One hundred and fifty pregnant women of the third trimester (study group) with cesarean section were enrolled in this study. Fifty pregnant women of the third trimester without cesarean section (control group) underwent abdominal ultrasonography and vaginal ultrasonography. The thickness of the lower uterine segment And pregnancy outcome. Results: The developing ratio of abdominal combined vaginal ultrasonography was 100.00%, higher than that of simple abdominal ultrasonography (P <0.05). The coincidence rate of combined examination was higher than that of simple abdominal ultrasound examination (P0.05) ; Pregnant women with study group with lower uterine scar grading increased thickness thinning, different grading scar pregnant women with lower uterine segment thickness difference was statistically significant (P <0.05), the study group of pregnant women with scar grade Ⅱ, Ⅲ, Ⅳ grade uterine scar The thickness of scar was significantly lower than that of the control group (P <0.05). The cesarean section rate and postpartum hemorrhage volume of grade Ⅱ, Ⅲ and Ⅳ scar were significantly higher than those of grade Ⅰ scar and control group (P <0.05) (P <0.05). The rate of cesarean section and intraoperative blood loss of grade Ⅱ, Ⅲ, Ⅳ scar were significantly higher than those of grade Ⅰ scar and control group (P < 0.05). Conclusion: Transabdominal transvaginal ultrasonography can improve the coincidence rate of uterine scar examination and understand the scar healing to guide the choice of mode of delivery.