To evaluate by ultrasonography, the lower uterine segment thickness of women with a previous cesarean delivery and determine a critical thickness above which safe vaginal delivery is predictable. A prospective observa...To evaluate by ultrasonography, the lower uterine segment thickness of women with a previous cesarean delivery and determine a critical thickness above which safe vaginal delivery is predictable. A prospective observational study of 71 antenatal women with previous cesarean delivery and 50 controls was carried out. Transabdominal and transvaginal ultrasonography were used in both groups to evaluate lower uterine segment thickness. The obstetric outcome in patients with successful vaginal birth and intraoperative findings in women undergoing cesarean delivery were correlated with lower segment thickness. The overall vaginal birth after cesarean section (VBAC) was 46.5%and VBAC success rate was 63.5%, the incidence of dehiscence was 2.82%, and there were no uterine ruptures. There was a 96%correlation between transabdominal ultrasonography with magnification and transvaginal ultrasonography. The critical cutoff value for safe lower segment thickness, derived from the receiver operator characteristic curve, was 2.5 mm. Ultrasonographic evaluation permits better assessment of the risk of scar complication intrapartum, and could allow for safer management of delivery.展开更多
目的分析储存式自体备血对疤痕子宫孕妇妊娠结局的影响。方法选择2013年1月1日—2014年12月31日该院疤痕子宫孕妇400例,采用随机数字表法分为实验组和对照组,对照组未行备血,实验组术前1 d采自体血200 m L备用,分析比较其妊娠结局。结...目的分析储存式自体备血对疤痕子宫孕妇妊娠结局的影响。方法选择2013年1月1日—2014年12月31日该院疤痕子宫孕妇400例,采用随机数字表法分为实验组和对照组,对照组未行备血,实验组术前1 d采自体血200 m L备用,分析比较其妊娠结局。结果分析实验组孕妇与胎儿采血前后生命体征变化情况,除舒张压出现了极小幅度的变化之外,并且这种变化并不属于临床意义中的血压下降。其他的指标均无明显变化,说明储存式自体备血对孕妇以及胎儿并无影响。比较两组孕妇采血前与回输后血液指标变化情况,发现Hb出现了小幅度的下降但是仍然处于正常范围,这一点可能与分娩后组织液回收和血液稀释有关,其他血液指标差异无统计学意义(P>0.05)。比较两组妊娠结局,两组在产后24 h出血量、新生儿出生体重、Apgar评分差异无统计学意义(P>0.05)。结论使用储存式自体备血方式减少异体输血血量,从而减少了异体输血带来的不良反应以及疾病的传播,整个采血前后操作安全有效,不会影响孕妇妊娠结局,值得临床推广使用。展开更多
文摘To evaluate by ultrasonography, the lower uterine segment thickness of women with a previous cesarean delivery and determine a critical thickness above which safe vaginal delivery is predictable. A prospective observational study of 71 antenatal women with previous cesarean delivery and 50 controls was carried out. Transabdominal and transvaginal ultrasonography were used in both groups to evaluate lower uterine segment thickness. The obstetric outcome in patients with successful vaginal birth and intraoperative findings in women undergoing cesarean delivery were correlated with lower segment thickness. The overall vaginal birth after cesarean section (VBAC) was 46.5%and VBAC success rate was 63.5%, the incidence of dehiscence was 2.82%, and there were no uterine ruptures. There was a 96%correlation between transabdominal ultrasonography with magnification and transvaginal ultrasonography. The critical cutoff value for safe lower segment thickness, derived from the receiver operator characteristic curve, was 2.5 mm. Ultrasonographic evaluation permits better assessment of the risk of scar complication intrapartum, and could allow for safer management of delivery.
文摘目的分析储存式自体备血对疤痕子宫孕妇妊娠结局的影响。方法选择2013年1月1日—2014年12月31日该院疤痕子宫孕妇400例,采用随机数字表法分为实验组和对照组,对照组未行备血,实验组术前1 d采自体血200 m L备用,分析比较其妊娠结局。结果分析实验组孕妇与胎儿采血前后生命体征变化情况,除舒张压出现了极小幅度的变化之外,并且这种变化并不属于临床意义中的血压下降。其他的指标均无明显变化,说明储存式自体备血对孕妇以及胎儿并无影响。比较两组孕妇采血前与回输后血液指标变化情况,发现Hb出现了小幅度的下降但是仍然处于正常范围,这一点可能与分娩后组织液回收和血液稀释有关,其他血液指标差异无统计学意义(P>0.05)。比较两组妊娠结局,两组在产后24 h出血量、新生儿出生体重、Apgar评分差异无统计学意义(P>0.05)。结论使用储存式自体备血方式减少异体输血血量,从而减少了异体输血带来的不良反应以及疾病的传播,整个采血前后操作安全有效,不会影响孕妇妊娠结局,值得临床推广使用。
