B超检查在妊娠疤痕子宫破裂预测价值.docVIP

B超检查在妊娠疤痕子宫破裂预测价值【摘要】目的:探讨应用 B超检查妊娠晚期瘢痕子宫预测子宫破裂的可行性。方法:回顾性分析300例孕妇,自妊娠 32～40周起连续进行子宫下段厚度及子宫下段瘢痕缺陷的观察。结果:300例孕妇的子宫下段在妊娠 32周以后均已形成 , 52例经 B超检查存在子宫下段瘢痕缺陷, 经手术证实为瘢痕子宫破裂的18例,B超诊断其中16例诊断为先兆子宫破裂,1例诊断为子宫破裂,超声诊断符合率为93.44%。结论:B超观察子宫下段瘢痕缺陷的方法可靠,可预测先兆子宫破裂。? 【关键词】瘢痕子宫; B超检查;子宫破裂;预测? 【中图分类号】R445.1 【文献标识码】C 【文章编号】1008-6455(2010)07-0232-02 Predictive the value of application in B ultrasonic examination on the scarred rupture of uterus of pregnancy ? Mao Jinjiang? 【Abstract】Objective:To discuss the feasibility of application in B ultrasonic examination to predict the scarred rupture of uterus of Pregnancy .Methods:retrospectiveto analyze 300 gravida, the thicknessand thescar defective of lower uterine segment were observed continuously by B ultrasound from33 weeks to 40 weeks of gravida having the history of cesarean section . Results:Lower ?uterine segment has all to form after 32weeks of 430 gravida, The scar defective of lower uterine segment were found in 52 cases by B ultrasound,16 cases were diagnosed threatened uterine rupture and 1 case was diagnoseduterine rupture confirmed by surgery. Ultrasonic diagnose accordance rate were 93.44%。Conclusion:Methods were reliable with B ultrasound we can observe the development of lower uterine segment and predict threatened uterine rupture .? 【Key words】scarred uterus; B ultrasonic examination; uterine rupture; prediction 妊娠子宫破裂是指发生于妊娠晚期及分娩期的子宫体部或子宫下段的裂伤[1]。剖宫产率的增高 ,瘢痕子宫妊娠也随之增多。剖宫产后阴道分娩虽已被证实安全、 可行 ,但瘢痕子宫破裂尤其是妊娠晚期的隐性子宫破裂因不易被发现 ,仍然是威胁母婴安全的严重并[2]。本文对2005年1月 ～2009年 12月期间在本院的300例孕妇进行回顾性分析 ,自妊娠 32～40周起连续进行子宫下段厚度及子宫下段瘢痕缺陷的观察,并经手术证实,旨在探讨超声检查在预测先兆子宫破裂的价值。? 1 资料与方法? 1.1 一般资料:300例孕妇均为本院产科产前检查及住院,均有过 1次少数有 2次的剖宫产史。年龄最小 22岁 ,最大 40岁。观察条件为:妊娠 32～40周 ,单胎头位。在胎头未完全入盆时做 B超检查 ,观察子宫下段的形成状况和瘢痕愈合情况,并与分娩及手术结果对比,其中196例行剖宫产术,104例经阴道分娩。? 1.2 方法? 1.2.1 仪器:采用美国PHILIPSHD11XE型超声诊断仪 , 探头频率为2-5MHz检查均对子宫下段前壁从切面与横切面测量二三次 ,计算其厚度的平均值。? 1.2.2 子宫下段厚度及子宫下段瘢痕缺陷的观察方法:①子宫下段厚度是否均匀与对称; ②子宫下段的三层结构是否完整 ,有无肌层缺损; ③子宫下段是否因推挤而产生不对称的羊膜囊向母体腹前壁膀胱方向膨出 。?