妊娠晚期瘢痕子宫下段厚度的影响因素分析

Study the influencing factors of the lower uterine segment thickness after cesarean delivery during the third trimester of pregnancy

目的：探讨妊娠晚期瘢痕子宫下段厚度的影响因素。方法：回顾性分析2011年6月至2013年12月于我院行磁共振成像（MRI）检查的妊娠晚期（36~40周）患者74例,其中有剖宫产史孕妇34例（剖宫产组）,经阴道分娩史孕妇40例（对照组）。在MRI图像上分别测量2组孕妇子宫下段的厚度,采用线性回归模型分析孕妇的年龄、孕周、剖宫产史、剖宫产的次数、距上次剖宫产的间隔时间等因素对子宫下段厚度的影响。结果：剖宫产组孕妇子宫下段厚度为（3.34±0.71）mm,对照组孕妇子宫下段厚度为（3.97±1.08）mm,2组比较差异有统计学意义（P〈0.05）。线性回归模型中,剖宫产史对子宫下段厚度的影响差异有统计学意义（P〈0.05）,孕妇的年龄、孕周、剖宫产的次数、距上次剖宫产的间隔时间对子宫下段厚度的影响差异均无统计学意义（P〉0.05）。结论：剖宫产史是影响妊娠晚期瘢痕子宫下段厚度的主要因素。

Objective： To explore the influencing factors of the lower uterine segment thickness after cesarean delivery during the third trimester of pregnancy. Methods： 74 pregnant women undergone magnetic resonance imaging （MRI） examination at third-trimester in our hostipal from June 2011 to December 2013 were include, 34 with a history of cesarean delivery and 40 control subjects with a history of vaginal delivery, the lower uterine segment thickness was measured on MRI. The maternal age, gestational age, previous cesarean, numbers of ce- sareans, interval time after cesarean influence on the lower uterine segment thickness were emphatically analyzed with a linear regression model. Results： The lower uterine segment was significantly thinner in women with a previous cesarean delivery compared with control subjects （3.34~0.71 versus 3.97~1.08 mm, P〈0.05）. In a linear regression model, the only variable retaining significance in the prediction of uterine wall thickness was previous cesarean delivery （P〈0.05）. Maternal age, gestational age, number of cesareans, and interval time after cesarean did not attain significance in the model （P〉0.05）. Conclusion： The previous cesarean delivery is the main factor influencing the lower uterine segment thickness after cesarean delivery during the third trimester of pregnancy.