超声对妊娠期不同类型子宫破裂的临床诊断价值

Clinical value of ultrasound in the diagnosis of different types of uterine rupture during pregnancy

目的探讨超声对妊娠期不同类型子宫破裂的临床诊断价值。方法选取我院产科经手术确诊的子宫破裂患者35例,其中完全性子宫破裂患者16例,不完全性子宫破裂患者19例,比较孕周及发生部位、超声图像特征,分析超声对不同类型子宫破裂的诊断情况。结果子宫破裂均以孕晚期多见(26/35);完全性子宫破裂发生部位比较差异无统计学意义;不完全性子宫破裂以剖宫产瘢痕处多发(89.5%,17/19)。超声对完全性子宫破裂的诊断准确率(81.3%,13/16)明显高于不完全性子宫破裂(31.6%,6/19),差异有统计学意义(P<0.05);其中超声诊断剖宫产瘢痕处完全性子宫破裂的诊断准确率为100%(6/6),而剖宫产瘢痕处不完全性子宫破裂的诊断准确率仅为29.4%(5/17)。超声对孕晚期不完全性子宫破裂的诊断准确率仅23.5%,均较其他孕周低,差异有统计学意义(P<0.05)。结论超声对完全性子宫破裂的诊断价值优于不完全性子宫破裂,尤其对于孕晚期及剖宫产瘢痕处不完全性子宫破裂的诊断价值较低。

Objective To explore the clinical value of ultrasound in the diagnosis of different types of uterine rupture during pregnancy.Methods A total of 35 cases with uterine rupture diagnosed by surgery in the department of obstetrics in our hospital were selected,including 16 cases of complete uterine rupture and 19 cases of incomplete uterine rupture.Gestational week and site of rupture,ultrasonic image characteristics were compared.The diagnostic accuracy of ultrasound for different types of uterine rupture were analyzed.Results Uterine rupture was more common in the third trimester(26/35),and there was no significant difference in the location of rupture in the complete rupture group.Incomplete uterine rupture was more common in cesarean scar(89.5%,17/19).The diagnostic accuracy of ultrasound for the complete rupture group(81.3%,13/16)was significantly higher than that of the incomplete rupture group(31.6%,6/19),the difference was statistically significant(P<0.05).The diagnostic accuracy of ultrasound in the diagnosis of complete uterine rupture in cesarean scar was 100%(6/6),while the diagnostic accuracy was 29.4%(5/17)for ultrasound in the diagnosis of the rupture at the scar of cesarean section in incomplete rupture cases.The diagnostic accuracy of ultrasound in the third trimester of pregnancy was 23.5%in patients with incomplete uterine rupture,which was lower than that of other gestational weeks,and the difference was statistically significant(P<0.05).Conclusion The diagnostic value of ultrasound is higher for patients with complete uterine rupture than that for incomplete uterine rupture,the diagnostic value of ultrasound for incomplete uterine rupture in late pregnancy and cesarean scar is lower.