经阴道超声检测孕晚期子宫前壁下段肌层厚度与术中子宫瘢痕情况对比分析  

Comparative analysis of the thickness of lower uterine segment of the anterior wall in late pregnancy measured by transvaginal ultrasound and uterine scar during operation

作　　者：李萍[1] 李利琼[1] 胡谢 刘敏[1] LI Ping;LI Liqiong;HU Xie;LIU Min(Department of Ultrasound Medicine,Leshan People's Hospital,Leshan Sichuan 614000,China)

机构地区：[1]乐山市人民医院超声医学科,四川乐山614000

出　　处：《中国妇产科临床杂志》2024年第3期220-223,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：四川省乐山市医学科研课题(21SZD186)。

摘　　要：目的探讨应用经阴道超声检测孕晚期子宫前壁下段肌层厚度,预测剖宫产术中子宫的瘢痕情况。方法从2019年6月至2022年2月在乐山市人民医院分娩且孕晚期接受经阴道超声检测子宫前壁下段肌层厚度的瘢痕子宫产妇中抽取120例,将产妇依据子宫前壁下段厚度分组,其中A组(<1.00 mm)、B组(1.0~2.0)mm、C组(>2.0 mm)各40例,比较三组患者术中瘢痕情况,以及术中瘢痕形成较差(Ⅱ级、Ⅲ级、Ⅳ级)的子宫前壁下段的肌层厚度。结果120例孕妇中,术中所见子宫瘢痕形成较差的孕妇共有27例;三组术中所见子宫瘢痕形成较差的比例对比,B组>C组低于A组(P<0.05);C组低于B组(P<0.05)。A组及B组的Ⅲ级、Ⅳ级所占比例均高于C组;在A组中,术中子宫瘢痕Ⅲ级所占比例最高。术中子宫瘢痕Ⅳ级的孕妇,子宫前壁下段肌层厚度<1 mm;且Ⅱ、Ⅲ、Ⅳ级孕妇平均子宫前壁下段肌层厚度依次降低(P<0.05)。结论对于经阴道超声检测孕晚期子宫前壁下段肌层厚度<2 mm,特别是<1 mm的孕妇,临床需提前采取措施以预防瘢痕破裂。Objective To investigate the application of the thickness of lower uterine segment of the anterior wall in late pregnancy measured by transvaginal ultrasound in predicting uterine scar during cesarean section.Methods A total of 120pregnant women with scarred uterus who received transvaginal ultrasonography for measuring the thickness of lower uterine segment of the anterior wall in late pregnancy and gave birth in the People's Hospital of Leshan from June 2019 to February 2022were selected as the research subjects.According to the thickness of lower uterine segment of the anterior wall measured in late pregnancy,the subjects were divided into<1.00 mm group,1.0-2.0 mm group and>2.0 mm group,with 40 cases in each group.The three groups were compared on intraoperative scar condition and the thickness of lower uterine segment of the anterior wall in women with poor(gradeⅡ,gradeⅢand gradeⅣ)scar formation during operation.Results Of the 120 pregnant women,27 had poor uterine scar formation during operation.The proportions of poor uterine scar formation in the 1.0-2.0 mm group and the>2.0 mm group were lower than that in the<1.00 mm group(P<0.05).The proportion of poor uterine scar formation in the>2.0 mm group was lower than that in the 1.0-2.0 mm group(P<0.05).The proportions of gradeⅢand gradeⅣuterine scar in the<1.00 mm group and the 1.0-2.0 mm group were higher than those in the>2.0 mm group.In the<1.0 mm group,the proportion of intraoperative gradeⅢuterine scar was the highest.Pregnant women with gradeⅣuterine scar during operation had the thickness of lower uterine segment of the anterior wall smaller than 1 mm.The average thickness of lower uterine segment of the anterior wall in pregnant women with gradeⅡ,gradeⅢ,and gradeⅣuterine scar decreased in order(P<0.05).Conclusion For pregnant women with thinner than 2 mm of lower uterine segment of the anterior wall measured by transvaginal ultrasound in late pregnancy,especially thinner than 1 mm,necessary measures should be taken in advance to pre

关 键 词：超声测量 前壁 子宫下段厚度 孕晚期 

分 类 号：R714.2[医药卫生—妇产科学]