经腹超声测量瘢痕子宫下段全层厚度预测不完全性子宫破裂的临床价值

Clinical value of scarred uterus lower uterine segment full thickness measured by transabdominal ultrasound in incomplete uterine rupture prediction

目的探讨经腹超声测量瘢痕子宫下段全层厚度预测不完全性子宫破裂(IUR)的临床价值。方法收集124例行择期剖宫产的瘢痕子宫孕妇的临床资料。所有孕妇均于晚孕期行经腹超声测量子宫下段全层厚度,根据剖宫产术中所见,分为研究组(发生IUR,n=12)和对照组(子宫下段无异常,n=112)。对比两组孕妇子宫下段全层厚度及两次剖宫产时间间隔,绘制受试者工作特征曲线评价经腹超声测量瘢痕子宫下段全层厚度预测IUR的价值。结果研究组子宫下段全层厚度小于对照组,两次剖宫产时间间隔短于对照组(均P<0.05)。以子宫下段全层厚度≤3.2 mm为截断值,其预测IUR的曲线下面积为0.951(P<0.05),灵敏度和特异度分别为83.33%和97.32%。结论经腹超声测量瘢痕子宫下段全层厚度对IUR具有较高的预测价值。

Objective To explore the clinical value of scarred uterus lower uterine segment full thickness measured by transabdominal ultrasound in incomplete uterine rupture(IUR) prediction. Methods The clinical data of 124 pregnant women with scarred uterus scheduled for cesarean section were collected. All pregnant women underwent transabdominal ultrasound to measure the full thickness of lower uterine segment in late pregnancy, and were divided into study group(developing IUR, 12 cases) and control group(without abnormalities in lower uterine segment,112 cases) according to surgical findings during cesarean section. Lower uterine segment full thickness and interval between two cesarean sections were compared between the two groups, and the receiver operating characteristic(ROC) curve was plotted to assess the value of scarred uterus lower uterine segment full thickness measured by transabdominal ultrasound in IUR prediction. Results The study group had minor uterine segment full thickness and shorter interval between two cesarean sections than the control group(all P<0.05). Lower uterine segment full thickness≤3.2 mm served as the cutoff value for IUR prediction, the area under the curve was 0.951(P<0.05), and the sensitivity and specificity were 83.33% and 97.32%, respectively. Conclusions Lower uterine segment full thickness of scarred uterus measured by transabdominal ultrasound is of higher predictive value for IUR.