超声检测孕晚期子宫下段全层厚度对疤痕子宫再次妊娠分娩的临床价值

目的探讨超声检测孕晚期子宫下段全层厚度对疤痕子宫再次妊娠分娩的临床价值。方法收集2013年4月至2013年12月疤痕子宫的产妇128例,孕晚期检测子宫下段全层厚度,67例子宫下段全层厚度≥3 mm(Ⅰ组),61例子宫下段全层厚度3 mm(Ⅱ组)。对病例的自然分娩率,再次剖宫产的术中及术后24 h出血量、术后血红蛋白、子宫收缩乏力、不全子宫破裂、子宫切口愈合欠佳、新生儿窒息的情况进行比较。结果Ⅰ组的自然分娩率高于Ⅱ组,Ⅰ组及Ⅱ组中再次剖宫产的术中及术后24 h出血量、术后血红蛋白及子宫收缩乏力、不全子宫破裂、子宫切口愈合欠佳的差异均有统计学意义(P0.05),新生儿窒息的差异无统计学意义(P0.05)。结论孕晚期检测子宫下段全层厚度以便选择孕妇分娩方式及评估再次剖宫产围手术期的风险,能减少母婴并发症的发生,对疤痕子宫再次妊娠分娩的安全性有一定的指导意义。

The effect of ultrasonic testing during late pregnancy in the lower uterine segment full thickness on the uterine scar pregnancy and childbirth.

Objective To investigate the effect of ultrasonic testing during late pregnancy in the lower uterine segment full thickness on the uterine scar pregnancy and childbirth. Methods Collet 128 cases of uterine scar in our hospital from 2013 April - 2013 year in December, Detection of lower uterine segment full thickness during late pregnancy, 67 cases of lower uterine segment full thickness ≥3 mm （ Group I ）, 61 cases of lower uterine segment full thickness 〈 3 mm （ Group II）. In these cases, natural delivery rate were compared. In some cases of cesarean section, intraoperative and postoperative 24 h amount of bleeding, postoperative hemoglobin, uterine atony, incomplete uterine rupture, uterine incision poor healing, neonatal asphyxia were compared. Results Natural childbirth rate of group I is higher than that of group II. In cesarean section operation of group I and group II , the differences of intraoperative and postoperative 24 h amount of bleeding, postoperative hemoglobin, uterine atony, incomplete uterine rupture, uterine incision poor healing were statistically significant （ P 〈 0.05 ）, there was no significant difference in neonatal asphyxia （ P 〉 0.05 ）. Conclusion Late pregnancy detection of lower uterine segment full thickness in order to choose the mode of delivery in pregnant women and to assess the risk again during caesarean operation, have a certain guiding significance to safety delivery on re pregnancy scar uterus, can reduce maternal complications.