ROC预测剖宫产后子宫瘢痕对再次妊娠子宫破裂的影响

ROC Predicts the Influence of Uterine Scar After Cesarean Section on Uterine Rupture in the Second Pregnancy

目的以ROC曲线分析妊娠期子宫瘢痕情况在剖宫产术后再次妊娠孕妇发生子宫破裂中价值。方法回顾性分析我院2017年10月至2019年10月收治的66例剖宫产术后再次妊娠孕妇的临床资料,根据其再次妊娠结局子宫破裂情况分为破裂组(n=29)和未破裂组(n=37)。比较两组研究对象妊娠期子宫瘢痕情况,利用ROC曲线分析子宫瘢痕情况预测剖宫产术后再次妊娠孕妇发生子宫破裂的价值,最后通过Spearman系数对剖宫产术后再次妊娠孕妇发生子宫破裂与瘢痕情况进行相关性分析。结果破裂组瘢痕厚度显著低于未破裂组,差异有统计学意义(P<0.05);破裂组瘢痕缺损显著高于未破裂组,差异有统计学意义(P<0.05)。经ROC分析,瘢痕厚度的下曲线面积为0.657;瘢痕缺损的下曲线面积为0.688。经相关性分析,剖宫产术后再次妊娠孕妇发生子宫破裂与瘢痕厚度呈负相关,与瘢痕缺损呈正相关,均有统计学意义(P<0.05)。结论妊娠期子宫瘢痕情况可以预测剖宫产术后再次妊娠孕妇发生子宫破裂的可能性,临床应当关注。

Objective To analyze the value of uterine scars during pregnancy in the occurrence of uterine rupture in pregnant women after cesarean section by ROC.Methods From October 2017 to October 2019,clinical data of 66 pregnant women undergoing re-pregnancy after cesarean section in our hospital was retrospectively analyzed.According to their re-pregnancy outcome,uterine rupture was divided into ruptured group(n=29)and unruptured group(n=37).Uterine scars during pregnancy were compared,and ROC curve was used to analyze uterine scars in predicting uterine rupture value in pregnant women after cesarean section.Finally,Spearman’s coefficient was used to analyze the correlation between uterine rupture and scar in pregnant women after cesarean section.Results The scar thickness in ruptured group was significantly lower than that in unruptured group with statistically significant difference(P<0.05).The scar defect in ruptured group was significantly higher than that in unruptured group with statistically significant difference(P<0.05).According to ROC analysis,the lower curve area of scar thickness was 0.657,the lower curve area of scar defect was 0.688.According to correlation analysis,uterine rupture occurrence in pregnant women after cesarean section was negatively correlated with scar thickness and positively correlated with scar defect(P<0.05).Conclusion Uterine scars during pregnancy could predict the possibility of uterine rupture in pregnant women after cesarean section.And clinical attention should be paid.