影像科学与光化学2025，Vol.43Issue(5)：68-74,7.DOI:10.7517/issn.1674-0475.2025.05.09
超声测量在评估剖宫产后再次妊娠胎盘植入风险中的应用
Application of Ultrasound Measurement in Evaluating the Risk of Placental Implantation in Subsequent Pregnancy after Cesarean Section
摘要
Abstract
Objective:Exploring the value of measuring the distance between the lower edge of the gestational sac and uterine scars,scar thickness during late pregnancy,and placental thickness using ultrasound in assessing the risk of placental implantation during postpartum cesarean section.Methods:From January 2023 to December 2023,351 pregnant women who were pregnant again after cesarean section in the ultrasound department of Mianyang Maternal and Child Health Hospital were selected.According to the presence or absence of placental implantation,they were divided into 20 cases of placental implantation group and 331 cases of non-placental implantation group.The risk factors of placental implantation after cesarean section were analyzed and the prediction model was constructed.Results:The age,number of pregnancies,number of induced abortions,distance between the lower edge of the gestational sac and uterine scars,scar thickness during late pregnancy,placental thickness,intraoperative blood volume,and quantified total score of placental implantation in the placental implantation group were significantly higher than those in the non-placental implantation group(P<0.05).The placental implantation group had a longer surgical time(P<0.05).According to binary logistic regression analysis,the number of induced abortions,the distance between the lower edge of the gestational sac and the uterine scar,intraoperative bleeding volume,and the quantified total score of placental implantation were identified as risk factors for placental implantation in postpartum cesarean section(P<0.05).The Hosmer-Lemeshow goodness-of-fit test showed that χ2=5.761,P=0.674,and the constructed prediction model had good predictive performance.The AUC was 0.858,the sensitivity and specificity were 83.4%and 100.0%,respectively,and the accuracy was 95.4%.Conclusion:The risk of placental implantation in postpartum cesarean section is related to multiple factors such as the number of induced abortions,the distance between the lower edge of the gestational sac and uterine scars,intraoperative bleeding volume,and the total score of placental implantation quantification.The constructed model has high predictive value.关键词
剖宫产/再次妊娠/胎盘植入/孕囊下缘与子宫瘢痕距离/晚孕期瘢痕厚度/胎盘厚度/价值Key words
cesarean section/subsequent pregnancy/placental implantation/the distance between the lower edge of the gestational sac and the uterine scar/late pregnancy scar thickness/placental thickness/value分类
医药卫生引用本文复制引用
陈琦,周青,蒋维静,刘星余,杜学文..超声测量在评估剖宫产后再次妊娠胎盘植入风险中的应用[J].影像科学与光化学,2025,43(5):68-74,7.基金项目
四川省妇幼保健协会科研课题(FXYB24). （FXYB24）
