超声检测中晚期肌层厚度变化趋势与瘢痕子宫再妊娠孕妇母婴结局的相关性研究

Study on the correlation between the change trend of muscle thickness detected by ultrasound and maternal and infant outcomes of scar uterus repregnancy

目的探究中晚期肌层厚度变化趋势与瘢痕子宫再妊娠孕妇母婴结局的相关性。方法回顾性选择2019年3月至2021年8月连云港市第二人民医院收治的瘢痕子宫再妊娠孕妇63例。按中晚期肌层厚度不同将其分为观察组(n=35,子宫肌层厚度>3 mm)和对照组(n=28,子宫肌层厚度≤3 mm)2组。对比分析两组孕妇分娩结局和心理状态;统计新生儿形态计量学指标和新生儿Apgar评分;采用Spearman法分析肌层厚度变化趋势与瘢痕子宫再妊娠孕妇母婴结局的相关性。结果观察组孕妇自然分娩率为71.43%,显著高于对照组(39.29%),且观察组孕妇产后出血量、住院时间、SAS评分和SDS评分为(213.72±16.27)mL、(4.84±0.89)d、(30.56±1.45)分、(31.14±3.09)分,均显著小于对照组[(286.81±21.09)mL、(8.23±1.27)d、(45.89±2.32)分、(43.45±2.08)分],差异均有统计学意义(P<0.05)。两组孕妇的子宫破裂率比较,差异无统计学意义(P>0.05)。观察组新生儿的出生体重以及出生后10 min的Apgar评分为(3.31±0.42)kg、(9.33±0.60)分,均显著高于对照组[(2.96±0.57)kg、(5.34±0.65)分],差异有统计学意义(P<0.05)。妊娠晚期子宫肌层厚度与产后出血量呈负相关(r=-0.568,P<0.05);与新生儿出生体重、新生儿Apgar评分(出生后1 min)、新生儿Apgar评分(出生后5 min)以及孕妇心理状态呈正相关(r=0.347、0.671、0.703、0.685,P<0.05)。结论中晚期肌层厚度变化趋势与瘢痕子宫再妊娠孕妇母婴结局存在一定相关性,因此在产前应通过超声诊断仪观察并明确肌层厚度,有利于改善再妊娠孕妇的母婴结局。

Objective To explore the correlation between the change trend of muscularis thickness and maternal and infant outcomes of scarred uterus repregnancy.Methods A total of 63 pregnant women with scarred uterus who were admitted to The Second People's Hospital of Lianyungang from March 2019 to August 2021 were retrospectively selected.They were divided into observation group(n=35,myometrium thickness>3 mm)and control group(n=28,myometrium thickness≤3 mm)according to myometrium thickness in middle and late stage.The general data,delivery outcome and psychological state of pregnant women in the two groups were compared and analyzed.The morphometric indicators and Apgar score of newborns were analyzed.Spearman method was used to analyze the correlation between the change trend of muscle thickness and maternal and infant outcomes of scar uterus repregnancy.Results The natural delivery rate of pregnant women in the observation group was 71.43%,which was significantly higher than that in the control group(39.29%),and the postpartum blood loss,length of hospital stay,SAS score and SDS score of pregnant women in the observation group were(213.72±16.27)mL,(4.84±0.89)d,(30.56±1.45)points,and(31.14±3.09)points,which were significantly lower than those in the control group[(286.81±21.09)mL,(8.23±1.27)d,(45.89±2.32)points,(43.45±2.08)points],the differences were statistically significant(P<0.05).There was no significant difference in the rate of uterine rupture between the two groups(P>0.05).The birth weight and Apgar score 10 min after birth in the observation group were(3.31±0.42)kg and(9.33±0.60)points,which wer significantly higher than those in the control group[(2.96±0.57)kg and(5.34±0.65)points],the differences were statistically significant(P<0.05).There was a negative correlation between myometrium thickness and postpartum blood loss in late pregnancy(r=-0.568,P<0.05).There was a positive correlation with birth weight,Apgar score(1 min after birth),Apgar score(5 min after birth)and psychological state of pregnant women(r=0.347,0.671,0.703,0.685;P<0.05).Conclusion There is a certain correlation between the change trend of muscle thickness in the middle and late stage and maternal and infant outcomes of pregnant women with scar uterus repregnancy.Therefore,the muscle thickness should be observed and determined by ultrasound diagnostic instrument before pregnancy,which is beneficial to improve maternal and infant outcomes of pregnant women with repregnancy.