Clinical significance of gestational interval time after cesarean section in the diagnosis of uterine scar pregnancy
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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。 Abstract:ObjectiveTo explore the clinical value of gestational interval time after cesarean section in the diagnosis of uterine scar pregnancy. MethodsThe 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. ResultsCompared 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%. ConclusionAfter 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. -
Key words:
- cesarean scar pregnancy /
- interval time /
- clinical diagnosis
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表 1 各组患者剖宫产术后再次妊娠间隔时间比较（Mean±SD）
指标 实验组（n=84） 对照组A（n=100） 对照组B（n=36） 对照组C（n=29） 对照组D（n=23） 间隔时间（周） 71.10±32.93 162.73±86.83 128.58±54.30 114.59±45.51 289.57±195.24 t — 9.752 5.904 5.530 5.346 P — <0.001 <0.001 <0.001 <0.001 
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表 2 两种诊断方式的有效率比较[n（%）]
诊断方式 疤痕妊娠 疑阵及其他 合计 阴道超声 58（69.05） 26（30.95） 84 间隔时间联合阴道超声 71（84.52） 13（15.48） 84 合计 129 39 168 统计值 χ2=5.643 P=0.018 –
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