CAJ | 학술논문

目的研究经阴道超声对剖宫产后再次妊娠早期子宫疤痕处肌层厚度检测的临床价值.方法回顾2012年1月至2013年12月剖宫产后再次妊娠在我院进行产检和分娩的124例孕妇,均经阴道超声对剖宫产术后再次妊娠早期子宫疤痕处肌层厚度进行检测,早期评估子宫疤痕愈合程度,并追踪其晚期剖宫产手术时疤痕愈合程度的评估情况或阴道分娩情况,统计疤痕子宫早期妊娠疤痕处肌层厚度检测评估子宫疤痕愈合程度的临床符合率.并与随机获得的50例疤痕子宫妊娠晚期子宫疤痕处肌层厚度检测来评估子宫疤痕愈合程度的对照组进行对比分析.结果研究组124例中剖宫产113例,经阴道顺产11例;疤痕子宫妊娠早期子宫疤痕愈合程度评估:Ⅰ级愈合32例,临床符合率100％;Ⅱ级愈合68例,临床符合率94.12％;Ⅲ级愈合24例,临床符合率95.83％,无完全性子宫破裂;随机获得的疤痕子宫妊娠晚期的对照组50例,Ⅰ级愈合符合率65.38％,Ⅱ级愈合符合率77.27％,Ⅲ级愈合符合率50％.结论剖宫产后再次妊娠早期子宫疤痕处肌层厚度检测能较准确评估子宫疤痕愈合程度,且优于单纯妊娠晚期对子宫疤痕厚度检测评估,为妇产科医生指导孕妇孕期保健、对疤痕子宫晚期妊娠子宫破裂风险的预测和分娩方式的选择提供有力依据,可降低疤痕子宫妊娠再次剖宫产率.
목적 연구경음도초성대부궁산후재차임신조기자궁파흔처기층후도검측적림상개치.방법 회고2012년1월지2013년12월부궁산후재차임신재아원진행산검화분면적124례잉부,균경음도초성대부궁산술후재차임신조기자궁파흔처기층후도진행검측,조기평고자궁파흔유합정도,병추종기만기부궁산수술시파흔유합정도적평고정황혹음도분면정황,통계파흔자궁조기임신파흔처기층후도검측평고자궁파흔유합정도적림상부합솔.병여수궤획득적50례파흔자궁임신만기자궁파흔처기층후도검측래평고자궁파흔유합정도적대조조진행대비분석.결과 연구조124례중부궁산113례,경음도순산11례;파흔자궁임신조기자궁파흔유합정도평고:Ⅰ급유합32례,림상부합솔100％;Ⅱ급유합68례,림상부합솔94.12％;Ⅲ급유합24례,림상부합솔95.83％,무완전성자궁파렬;수궤획득적파흔자궁임신만기적대조조50례,Ⅰ급유합부합솔65.38％,Ⅱ급유합부합솔77.27％,Ⅲ급유합부합솔50％.결론 부궁산후재차임신조기자궁파흔처기층후도검측능교준학평고자궁파흔유합정도,차우우단순임신만기대자궁파흔후도검측평고,위부산과의생지도잉부잉기보건、대파흔자궁만기임신자궁파렬풍험적예측화분면방식적선택제공유력의거,가강저파흔자궁임신재차부궁산솔.
Objective To investigates the clinical value of transvaginal ultrasound in detecting muscle layer thickness of uterine scar in early re-pregnancy after cesarean section.Methods By using transvaginal ultrasound,muscle thickness of uterine scar in early pregnancy were measured to assess the uterine scar healing of 124 secundigravida after cesarean section in our hospital from January 2012 to December 2013.Uterine scar healing degree in early period was assessed and then uterine scar healing after cesarean delivery or vaginal delivery was assessed again.Clinical compliance rates were counted by measuring the scars muscular thickness in early pregnancy as control group.Results In the 124 cases of the study group,113 cases were cesarean delivery,11 cases were spontaneous vaginal delivery.The result of assessing uterine scar healing degree in early pregnancy:32 cases were grade Ⅰ healing,clinical compliance rate was 100％; 68 cases were grade Ⅱ] healing,clinical compliance rate was 94.12％; 24 cases were grade Ⅲ healing,clinical compliance rate was 95.83％; no complete uterine rupture found.In the 50 cases of the control group,class Ⅰ healing compliance rate was 65.38％,class Ⅱhealing compliance rate was 77.27％,class Ⅲ healing compliance rate was 50％.Conclusion The uterine scar healing degree can be assessed with higher accuracy by measuring the thickness of the uterine scar myometrium in early second pregnancy after cesarean.It provides a strong basis for the obstetrician in guiding prenatal care for pregnant women,predicts the risk of uterine rupture in late pregnancy with uterine scar,and suggests the way of delivery,thus reduces the rate of cesarean again.