瘢痕子宫妊娠晚期子宫下段厚度与分娩情况的关联性探讨

Correlation between the Thickness of the Lower Uterine Segment of the Uterine Scar in Late Pregnancy And Delivery

目的观察子宫下段厚度与瘢痕子宫妊娠晚期患者分娩孕周、妊娠结局的关系。方法选取2017年6月1日-2019年6月30日某院瘢痕子宫孕妇81例,均再次实施剖宫产,依据子宫下段厚度分为A组(n=43,子宫下段厚度>3毫米)及B组(n=38,子宫下段厚度≤3毫米),对比两组一般资料、分娩情况,研究妊娠晚期子宫下段厚度与分娩情况关联性。结果 A组产后出血量(232.81±64.08)毫升少于B组(291.35±70.11)毫升,新生儿体质量(3196.78±196.35)克、新生儿出生1分钟Apgar评分(9.12±0.34)分及5分钟评分(9.59±0.21)分,高于B组的(2996.54±181.32)克、(8.32±0.40)分、(8.87±0.30)分,P<0.05,差异具有统计学意义;妊娠晚期(38周~40周)子宫下段厚度与剖宫产患者产后出血量(r=-0.417)存在负相关关系,与分娩孕周、新生儿体质量、新生儿出生1分钟及5分钟时Apgar评分(r=0.481、0.487、0.636、0.637)存在正相关关系,P<0.05。结论妊娠晚期子宫下段厚度与瘢痕子宫孕妇分娩情况存在一定相关性,通过彩色多普勒超声诊断仪及早观察子宫下段厚度,利于确定分娩孕周,改善再次妊娠分娩结局。

Objective To observe the relationship between the thickness of the lower segment of the uterus and the gestational age and pregnancy outcomes of patients with scarred uterus in late pregnancy.Methods A total of 81 pregnant women with scar uterus in a hospital from June 1,2017 to June 30,2019 were selected,and all were performed cesarean section again,according to the thickness of the lower segment of uterus,they were divided into group A(n=43,thickness of lower uterine segment was greater than 3 mm)and group B(n=38,thickness of lower uterine segment was less than 3 mm),the general information and delivery status of the two groups were compared,and the correlation between the thickness of the lower uterine segment in the third trimester and the delivery status was studied.Results The amount of postpartum hemorrhage(232.81±64.08)ml in group A was less than that in group B(291.35±70.11)ml,the neonatal body weight was(3196.78±196.35)g,and the Apgar score at 1 minute(9.12±0.34)points and 5 minutes(9.59±0.21)points of the newborn was higher than that of group B(2996.54±181.32)g,(8.32±0.40)points,(8.87±0.30)points(P<0.05);there was a negative correlation between the thickness of the lower uterine segment in the third trimester(38 to 40 weeks)and the postpartum hemorrhage(r=-0.417)in cesarean patients,and there was a positive correlation with the Apgar scores(r=0.481,0.487,0.636,0.637)at the gestational age of the childbirth,the weight of the newborn,and the birth of the newborn at 1 and 5 minutes(P<0.05).Conclusion There is a correlation between the thickness of the lower uterine segment in the third trimester and the delivery of pregnant women with scar uterus,early observation of the thickness of the lower segment of the uterus by color Doppler ultrasound in the clinic is conducive to determining the gestational week of labor and improving the outcome of childbirth again.