剖宫产产妇再次妊娠子宫下段的超声影像学特征分析  

Analysis on ultrasound imaging features of lower uterine segment in subsequent pregnant women after cesarean section

作　　者：聂敦利[1] 张雷[1] 

机构地区：[1]成都市第一人民医院妇产科,四川成都610041

出　　处：《中国妇幼保健》2016年第6期1288-1289,共2页Maternal and Child Health Care of China

基　　金：四川省科技厅软科学项目(2013ZR0171)

摘　　要：目的观察剖宫产产妇再次妊娠子宫下段的超声影像学特征及临床价值。方法选取2012年10月-2014年6月于成都市第一人民医院接受超声检查的800例产妇。将400例有剖宫产史者（均于子宫下段做横切口行剖宫产）设为观察组,200例顺产后再次妊娠的产妇设为对照Ⅰ组,200例初产妇设为对照Ⅱ组。3组产妇均在超声检查下观察其子宫下段的特征,并测量子宫下段的肌层厚度。结果观察组产妇的瘢痕位置在超声检查过程中有低回声肌层局部明显变薄、肌层边界模糊、回声增强等表现。分娩时均再次选择剖宫产方式,手术过程中共6例发生子宫先兆破裂。3组产妇妊娠35周后的子宫下段肌层厚度均明显薄于妊娠20-25周时的肌层厚度;对照Ⅰ组和对照Ⅱ组孕20-25周及孕35周后的子宫下段肌层厚度均厚于观察组。在超声检查中,观察组6例出现肌层消失征兆。结论在超声下观察剖宫产后再次妊娠产妇的子宫下段特征能够提早发现潜在的影响分娩的风险因素,为产妇选择分娩方式提供依据,有助于保障母婴安全。Objective To observe ultrasound imaging features of lower uterine segment and clinical value in subsequent pregnant women after cesarean section. Methods Eight hundred pregnant women receiving ultrasonography in the hospital from October 2012 to June2014 were selected and divided into three groups. Four hundred women with cesarean section history（ transverse incision cesarean section in lower uterine segment） were included into observation group,two hundred women after natural labor were included into control one group,two hundred primiparous women were included into control two group. Ultrasound imaging features of lower uterine segment in the three groups were observed,the thicknesses of lower uterine segment were measured. Results In observation group,low echo muscle layer of scar position thinned,the boundary of muscular layer was fuzzy,echo enhanced. The women chose cesarean delivery again,threatened rupture occurred in 6 cases. The thicknesses of lower uterine segment after 35 gestational weeks were significantly thinner than those during 20- 25 gestational weeks in the three groups; the thicknesses of lower uterine segment during 20-25 gestational weeks and after 35 gestational weeks in control one group and control two group were thicker than those in observation group. Disappearance of muscular layer signs occurred in 6cases in observation group during ultrasonography. Conclusion Observing ultrasound imaging features of lower uterine segment in subsequent pregnant women after cesarean section can detect potential and early risk factors of delivery,provide a basis for choose of delivery modes,and ensure maternal and infantile safety.

关 键 词：再次妊娠 超声检查 剖宫产 子宫下段 

分 类 号：R719[医药卫生—妇产科学]