前次剖宫产时的分娩对后续妊娠子宫下段厚度的影响。
Impact of labor at prior cesarean on lower uterine segment thickness in subsequent pregnancy.
机构信息
Department of Obstetrics and Gynecology, Faculty of Medicine, Hôpital Sainte-Justine, Université de Montréal, Montréal, QC, Canada.
出版信息
Am J Obstet Gynecol. 2010 Jun;202(6):563.e1-7. doi: 10.1016/j.ajog.2009.10.894. Epub 2009 Dec 29.
OBJECTIVE
The objective of the study was to identify the factors associated with sonographic lower uterine segment (LUS) thickness near term in women with prior low transverse cesarean.
STUDY DESIGN
A prospective cohort study of women with a single prior low transverse cesarean was conducted. LUS thickness was quantified by transabdominal ultrasound with repeated transvaginal measurement when necessary. The thinnest measurement was considered as the dependent variable. Potential related factors were evaluated with nonparametric analyses and multivariate logistic regressions.
RESULTS
Two hundred thirty-five women were recruited at a mean gestational age of 36.7 +/- 1.3 weeks. The full LUS was thicker in women who had their previous cesarean during the latent phase (2.8 mm; interquartile [IQ], 2.0-3.3 mm) or the active phase of labor (3.1 mm; IQ 2.5-3.9 mm) than in women with previous cesarean prior to labor (2.4 mm; IQ 2.0-3.2 mm). The association remained significant after adjustment for potential confounders.
CONCLUSION
Presence of labor at previous cesarean is associated with a thicker LUS in a subsequent pregnancy.
目的
本研究旨在确定既往行子宫下段剖宫产术（LSCS）的孕妇临近分娩时子宫下段（LUS）厚度的相关因素。
研究设计
对既往行子宫下段剖宫产术的单胎孕妇进行前瞻性队列研究。采用经腹超声对 LUS 厚度进行定量检测，必要时重复经阴道测量。最薄的测量值被视为因变量。采用非参数分析和多变量逻辑回归评估潜在的相关因素。
结果
共招募了 235 名孕妇，平均孕龄为 36.7 +/- 1.3 周。与在临产前行 LSCS 的孕妇（2.8 毫米；四分位间距 [IQR]，2.0-3.3 毫米）或在临产时行 LSCS 的孕妇（3.1 毫米；IQR 2.5-3.9 毫米）相比，在产前行 LSCS 的孕妇的完整 LUS 更厚（2.4 毫米；IQR 2.0-3.2 毫米）。在调整了潜在混杂因素后，这种关联仍然显著。
结论
既往 LSCS 时存在临产与随后妊娠时 LUS 较厚相关。
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