剪切波弹性成像预测疤痕子宫再次妊娠分娩方式的可行性分析

Feasibility analysis of shear wave elastic imaging to predict delivery mode of scar uterus re-pregnancy

目的:探讨剪切波弹性成像(SWE)预测疤痕子宫再次妊娠分娩方式的可行性。方法:选取2021年8月—2023年10月于郓城县人民医院进行产前检查的70例疤痕子宫再次妊娠产妇为研究对象,均实施SWE检查,总结产妇的疤痕分级、子宫下段厚度、弹性评分及分娩方式。结果:Ⅱ、Ⅲ、Ⅳ级疤痕产妇子宫下段厚度(1.89±0.24)mm小于Ⅰ级疤痕产妇的(4.50±0.31)mm,差异有统计学意义(P<0.001);Ⅰ级疤痕产妇阴道分娩率29.63%高于Ⅱ、Ⅲ、Ⅳ级疤痕产妇的6.25%,剖宫产分娩率70.37%低于Ⅱ、Ⅲ、Ⅳ级疤痕产妇的93.75%,差异有统计学意义(P<0.001);弹性评分1分产妇阴道分娩率43.75%高于弹性评分2、3分产妇的7.89%,剖宫产分娩率56.25%低于弹性评分2、3分产妇的92.11%,差异有统计学意义(P<0.001)。结论:SWE可通过疤痕分级、厚度测量、弹性评分等预测疤痕子宫再次妊娠产妇的分娩方式。

Objective To investigate the feasibility of shear wave elastography(SWE)in predicting the delivery mode of scar uterus re-pregnancy.Methods 70 pregnant women with scarred uterus who underwent prenatal examinations at Yuncheng County People's Hospital from August 2021 to October 2023 were selected as the research subjects and implement SWE examination,and the scar grade,lower uterine thickness,elastic score and delivery mode were summarized.Results The thickness of lower uterine segment in gradeⅡ,ⅢandⅣscar pregnant women(1.89±0.24)mm was significantly smaller than that in gradeⅠscar pregnant women,which was(4.50±0.31)mm,and the difference was statistically significant(P<0.001).The vaginal delivery rate of gradeⅠscar pregnant women(29.63%)was significantly higher than that of gradeⅡ,Ⅲ,Ⅳscar pregnant women(6.25%),and the cesarean section delivery rate(70.37%)was significantly lower than that in gradeⅡ,Ⅲ,Ⅳscar pregnant women(93.75%),and the difference was statistically significant(P<0.001).The vaginal delivery rate in elastic score 1 pregnant women(43.75%)was significantly higher than that in elastic score 2 and 3 pregnant women(7.89%),and the cesarean section delivery rate(56.25%)was significantly lower than that in elastic score 2 and 3 pregnant women(92.11%),and the difference was statistically significant(P<0.001).Conclusion SWE can predict the delivery mode of pregnant women with second pregnancy of scarred uterus by scar grading,thickness measurement and elasticity score.