彩色多普勒超声鉴别剖宫产子宫瘢痕妊娠与非瘢痕妊娠的价值

Values of color Doppler ultrasound in identifying scar pregnancy and none scar pregnancy for women who ever experienced uterine-incision delivery

目的探讨彩色多普勒超声鉴别剖宫产子宫瘢痕妊娠与非瘢痕妊娠的价值。方法按照孕囊位置情况将95例剖宫产再次妊娠的孕妇分为实验组(CSP)25例和对照组(孕囊位置正常,妊娠物完全位于宫腔内)70例。对被研究者进行彩色多普勒超声检查。观察超声影像特点、子宫瘢痕处超声情况、瘢痕肌层平均厚度等。结果实验组切口肌层变薄,连续性存在部分中断的情况,回声紊乱无序,肌层血流少。对照组回声基本均匀。两组首次检查孕囊血供血流指数S/D、血流指数RI差异无统计学意义(P>0.05);两组宫颈长度对比,差异无统计学意义(P>0.05);药物终止妊娠后,实验组血流指数S/D、血流指数RI低于对照组和首次检查时,有统计学差异(P<0.05)。实验组瘢痕肌层平均厚度低于对照组,有统计学差异(P<0.05)。结论彩色多普勒超声鉴别CSP有较高价值,临床特点明显,可辅助临床诊断。

Objective To explore the values of color Doppler ultrasound in identifying scar pregnancy and none scar pregnancy for women who ever experienced uterine-incision delivery. Methods 95 cases of pregnancy those who ever experienced cesarean section delivery were randomly divided into experiment group（ cesarean scar pregnancy,CSP,n= 25） and control group（ gestational sac located in the uterine cavity but not on the scar,n = 70）. They were tested by color doppler ultrasound. The ultrasonic imaging characteristics,ultrasonic of scar place,average thickness of muscle layer on scar place were observed. Results Incision muscle layer was thinning,continuity was partly interrupted,echo was disordered and lack of blood flow in the experimental group.The echo was basically uniform in the control group. There had no significant difference on the pregnant bursa blood supply flow index S/D and RI on first examination of the two groups（ P 0. 05）. There had no significant difference on the cervical length for the two groups（ P 0. 05）. The flow index S/D and flow index RI in the experiment group decreased significantly after medication termination compared with this first examination and lower than the control group（ P0.05）. The average muscular thickness scar of the experiment group was lower than the control group（ P0.05）.Conclusions It has high values of color Doppler ultrasound in identifying CPS,it has obvious clinical characteristics,and can be used for assist clinical diagnosis.