剖宫产后再次妊娠间隔时间在子宫疤痕妊娠诊断中的价值
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摘要
目的研究剖宫产术后再次妊娠间隔时间在子宫疤痕妊娠诊断和鉴别中的参考价值。方法以剖宫产术后再次妊娠妇女作为研究对象,选择84例子宫疤痕妊娠的患者作为实验组,随机选择100例正常宫内妊娠妇女作为对照组A,36例宫颈妊娠作为对照组B,29例不全流产患者作为对照组C,23例妊娠性滋养层细胞疾病患者作为对照组D,比较各组间两次妊娠间隔时间的差异。计算实验组间隔周数P75作为诊断切割值,然后切割值P75联合阴道超声检查与单独阴道超声检查对子宫疤痕妊娠诊断有效率的差异。结果相比较于对照组,子宫瘢痕妊娠患者两次妊娠间隔时间更短(P<0.05);切割值P75联合阴道超声检查与单独阴道超声检查对子宫瘢痕妊娠诊断的有效率差异有统计学意义(P<0.05),其中,间隔时间联合阴道超声诊断有效率为84.52%,单独阴道超声检查有效率为69.05%。结论剖宫产术后再次妊娠间隔时间短,则出现子宫瘢痕妊娠的危险性高,其联合阴道超声检查对临床上子宫瘢痕妊娠的诊断有一定意义。
Objective To explore the clinical value of gestational interval time after cesarean section in the diagnosis of uterine scar pregnancy. Methods The pregnant women after cesarean section were selected as the research object. A total of 84 cases of uterine scar pregnancy were choosed as experimental group. A total of 100 cases of normal intrauterine pregnancy were randomly selected as control group A, 36 cases of cervix pregnancy as control group B, 29 cases of incomplete abortion as control group C, 23 cases of gestational trophoblastic disease as control group D. The differences of pregnancy interval time between each group were compared. The interval weeks P75 of the experimental group was calculated as the diagnostic cutting value. The difference of the diagnostic efficiency of P75 combined with vaginal ultrasonography and vaginal ultrasonography alone in uterine scar pregnancy was calculated. Results Compared with the control group, the gestational interval time of patients with uterine scar pregnancy was significantly shorter(P<0.05). The effective rate of P75 combined with vaginal ultrasonography for diagnosis of uterine scar pregnancy was significantly different from that of vaginal ultrasonography alone(P<0.05). Among them, the effective rate of P75 combined with vaginal ultrasonography at the interval of weeks was 84.52%, and that of vaginal ultrasonography alone was 69.05%. Conclusion After cesarean section, short pregnancy interval time make a high risk of uterine scar pregnancy. Its combination with vaginal ultrasound examination is helpful for the clinical diagnosis of uterine scar pregnancy.
Objective To explore the clinical value of gestational interval time after cesarean section in the diagnosis of uterine scar pregnancy. Methods The pregnant women after cesarean section were selected as the research object. A total of 84 cases of uterine scar pregnancy were choosed as experimental group. A total of 100 cases of normal intrauterine pregnancy were randomly selected as control group A, 36 cases of cervix pregnancy as control group B, 29 cases of incomplete abortion as control group C, 23 cases of gestational trophoblastic disease as control group D. The differences of pregnancy interval time between each group were compared. The interval weeks P75 of the experimental group was calculated as the diagnostic cutting value. The difference of the diagnostic efficiency of P75 combined with vaginal ultrasonography and vaginal ultrasonography alone in uterine scar pregnancy was calculated. Results Compared with the control group, the gestational interval time of patients with uterine scar pregnancy was significantly shorter(P<0.05). The effective rate of P75 combined with vaginal ultrasonography for diagnosis of uterine scar pregnancy was significantly different from that of vaginal ultrasonography alone(P<0.05). Among them, the effective rate of P75 combined with vaginal ultrasonography at the interval of weeks was 84.52%, and that of vaginal ultrasonography alone was 69.05%. Conclusion After cesarean section, short pregnancy interval time make a high risk of uterine scar pregnancy. Its combination with vaginal ultrasound examination is helpful for the clinical diagnosis of uterine scar pregnancy.
引文
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[7]郑冬仙,姜明霞,方娟,等.疤痕子宫产妇剖宫产术后切口感染病原菌分布及危险因素分析[J].中国消毒学杂志,2018,35(9):663-5.
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[11]王联芬.疤痕子宫再次妊娠严重并发症的预防与处理[J].养生保健指南,2017,22(28):320-4.
[12]Giampaolino P,De Rosa N,Morra I,et al.Management of cesarean scar pregnancy:a single-institution retrospective review[J].Biomed Res Int,2018,52(10):6486407-15.
[13]韩大芬.早孕期剖宫产瘢痕妊娠的临床及病理特点分析[J].世界临床医学,2016,10(3):230-4.
[14]Nguyen-Xuan HT.R lousquy and E barranger,diagnosis,treatment,and follow-up of cesarean scar pregnancy[J].Gynecol Obstet Fertil,2014,42(7/8):483-9.
[15]陈桃英,张雅萍,胡志刚.少见部位异位妊娠的超声诊断与鉴别诊断[J].实用医学杂志,2010,26(8):1403-5.
[16]时培景.剖宫产切口妊娠患者清宫前血β-hCG,CSM厚度,RI与术中出血量的关系[J].山东医药,2018,58(21):67-9.
[17]瞿薇花,唐震.子宫切口瘢痕妊娠的MRI诊断[J].医学影像学杂志,2016,26(1):175-7.
[18]许凤.宫腔镜在剖宫产瘢痕妊娠和宫颈妊娠治疗中的应用价值评价[J].按摩与康复医学,2018,9(21):34-5.
[2]马金春,叶聪.疤痕子宫再妊娠孕产妇经阴道分娩的安全性研究[J].中外女性健康研究,2018,25(15):13-4.
[3]Sel G,Sucu S,Harma M,et al.Successful management of cesarean scar pregnancy with vacuum extraction under ultrasound guidance[J].Acute Med Surg,2018,5(4):358-61.
[4]Docheva N,Slutsky ED,Borella N,et al.The rising triad of cesarean scar pregnancy,placenta percreta,and uterine rupture:a case report and comprehensive review of the literature[J].Case Rep Obstet Gynecol,2018,39(12):8797643-56.
[5]贾莉,周娟,魏霞霞,等.疤痕子宫妊娠妇女经产道分娩的可行性、安全性和相关危险因素分析[J].现代生物医学进展,2015,15(33):6516-8,6405.
[6]孟宏霞,何庆华.剖宫产后疤痕子宫再次妊娠分娩方式的选择及其影响因素分析[J].内蒙古医学杂志,2018,50(9):1083-4.
[7]郑冬仙,姜明霞,方娟,等.疤痕子宫产妇剖宫产术后切口感染病原菌分布及危险因素分析[J].中国消毒学杂志,2018,35(9):663-5.
[8]王玉霞.剖宫产术后子宫疤痕妊娠的临床诊治[J].医学信息,2018,31(10):48-50.
[9]霍亚丽,王玉贤,李俊南.剖宫产瘢痕部位妊娠诊疗现状与进展[J].医药前沿,2017,7(11):6-8.
[10]刘志.子宫疤痕处妊娠诊断和治疗的最新进展[J].医药前沿,2017,7(25):8-12.
[11]王联芬.疤痕子宫再次妊娠严重并发症的预防与处理[J].养生保健指南,2017,22(28):320-4.
[12]Giampaolino P,De Rosa N,Morra I,et al.Management of cesarean scar pregnancy:a single-institution retrospective review[J].Biomed Res Int,2018,52(10):6486407-15.
[13]韩大芬.早孕期剖宫产瘢痕妊娠的临床及病理特点分析[J].世界临床医学,2016,10(3):230-4.
[14]Nguyen-Xuan HT.R lousquy and E barranger,diagnosis,treatment,and follow-up of cesarean scar pregnancy[J].Gynecol Obstet Fertil,2014,42(7/8):483-9.
[15]陈桃英,张雅萍,胡志刚.少见部位异位妊娠的超声诊断与鉴别诊断[J].实用医学杂志,2010,26(8):1403-5.
[16]时培景.剖宫产切口妊娠患者清宫前血β-hCG,CSM厚度,RI与术中出血量的关系[J].山东医药,2018,58(21):67-9.
[17]瞿薇花,唐震.子宫切口瘢痕妊娠的MRI诊断[J].医学影像学杂志,2016,26(1):175-7.
[18]许凤.宫腔镜在剖宫产瘢痕妊娠和宫颈妊娠治疗中的应用价值评价[J].按摩与康复医学,2018,9(21):34-5.