腹部超声诊断剖宫产后再次妊娠子宫疤痕破裂的临床研究

Diagnosis of uterine scar defect by abdominal ultrasonography in re-pregnancy after cesarean operation

摘要:

目的  探讨超声检查对剖宫产后子宫前壁下段肌层疤痕破裂的诊断价值，以指导临床及时采取必要的治疗措施，保障母胎安全。方法  腹部超声检查有剖宫产史并再次妊娠至中、晚期的孕妇，诊断子宫前壁下段肌层疤痕缺陷82例。其中局部肌层菲薄（厚度<1.0 mm）49例，局部肌层缺失33例。上述所有患者在超声检查后12 h内行再次剖宫产术，其中77例术中成功探查瘢痕。将术前超声检查结果与术中所见比较，评价超声检查对子宫疤痕破裂的诊断价值。结果  超声诊断前壁下段肌层疤痕缺陷与手术结果对照，符合率为87.0%，其中诊断子宫破裂及不全破裂的符合率为84.4%。结论  超声检查可准确评估剖宫产后再次妊娠时子宫疤痕缺陷，对临床医师及时采取必要治疗措施有重要指导意义。

Abstract:

Objective To discuss the value of ultrasonography in diagnosing uterine scar defect during the period of pregnancy after cesarean operation so as to take necessary treatment timely to ensure the maternal and fetal safety. Methods Ultrasonography was used to check the pregnant women in their second or third trimester of re-pregnancy after cesarean operation, and 82 women were diagnosed as uterine scar defect. Among them 49 cases had thin myometrium (< 1.0 mm), and 33 cases had local myometrium deletion. Cesarean was operated again within 12 hours after ultrasound examination. The uterine scars were successfully explored in 77 cases during operation, and the results of ultrasonography before operation and the findings during operatin were compared. Results The diagnostic coincidence rate of ultrasound approach was 87.0% for uterine scar defect and 84.4% for rupure of uterine scar. Conclusions Ultrasonography can accurately assess ulterine scar defect during re-pregnancy after cesarean operation.