超声检测子宫下段瘢痕缺陷对瘢痕子宫再次妊娠分娩方式选择临床价值.docVIP

超声检测子宫下段瘢痕缺陷对瘢痕子宫再次妊娠分娩方式选择临床价值 　　【摘要】 目的 探讨超声检测子宫下段瘢痕缺陷对瘢痕子宫再次妊娠分娩方式选择的临床价值。方法 118例早孕证实有子宫瘢痕缺陷的妊娠晚期孕妇设为观察组， 并选择同期118例检查无子宫瘢痕缺陷的妊娠晚期瘢痕子宫孕妇设为对照组， 对两组孕妇均进行超声检查， 比较其子宫前壁下段厚度、分娩方式， 记录观察组不同瘢痕级别孕妇妊娠结局。结果 观察组孕妇子宫前壁下段厚度明显低于对照组， 且不同瘢痕级别间子宫前壁下段厚度比较， 差异具有统计学意义（P0.05）。观察组孕妇剖宫产率为52.54%（62/118）， 显然高于对照组的32.20%（38/118）， 差异具有统计学意义（χ2=9.9953， P0.05）。新生儿窒息程度遂孕妇瘢痕级别升高而加重， 且瘢痕级别越高其发生率越高；不同瘢痕级别间发生率比较， 差异具有统计学意义（P0.05）。结论 临床中对瘢痕子宫再次妊娠采用超声检查， 可为临床预测子宫破裂风险及选择正确分娩方式起到指导性作用， 值得推广。 　　【关键词】 瘢痕子宫；超声诊断；再次妊娠；临床价值 　　DOI：10.14163/j.cnki.11-5547/r.2018.06.002 　　【Abstract】 Objective To discuss the clinical value of ultrasonic detection of lower uterine scar defect on mode of delivery of scar uterine re-pregnancy. Methods There were 118 pregnant women confirmed with uterine scar defect in late pregnancy as observation group， and concurrent 118 pregnant women confirmed without uterine scar defect in late pregnancy as control group. Two groups of pregnant women were examined by ultrasound to compare the thickness of the lower anterior wall thickness of the uterus and mode of delivery. The pregnancy outcome of pregnant women with different scar levels in the observation group was recorded. 　　Results The observation group had obviously lower lower anterior wall thickness of the uterus than the control group， and there was statistically significant difference in lower anterior wall thickness of the uterus in different scar levels （P0.05）. The observation group had obviously higher cesarean section rate as 52.54% （62/118） than 32.20% （38/118） in the control group， and the difference was statistically significant （χ2=9.9953， P0.05）. Severe asphyxia and mild asphyxia in newborns are positively related to the level of parturients， and the higher the scar level， the higher the incidence. There was statistically significant difference in incidence of different scar levels （P0.05）. 　　Conclusion In clinic， ultrasonic detection for re-pregnant women with scar uterine plays a guiding role in predicting the ri