Fukuda M, Shimizu T, Ihara Y, Fukuda K, Natsuyama E, Mochizuki M
Fukuda Ladies Clinic, Ako, Japan.
Arch Gynecol Obstet. 1991;248(3):129-38. doi: 10.1007/BF02390090.
Two hundred and sixteen transverse caesarean section scars were examined sonographically near term by a conventional method (175 scars) and a new method (41 scars). The new method consisted of obtaining a transabdominal longitudinal scan by the conventional method and also by a 3M conductor, a transabdominal frontal scan to give a surface view of the scar, and transperineal and transvaginal longitudinal scans. The new method was used from 16 weeks of gestation onwards. Of 41 scars scanned by the new method, 31 showed good healing, being more than 2 mm in thickness throughout; 10 scars showed poor healing with a thickness of less than 2 mm and loss of continuity. Of 31 patients with good healing, 8 delivered vaginally and the remaining 23 patients had repeat caesarean sections for other obstetric indications. All patients with ultrasound evidence of poor healing had repeat caesarean sections. At operation the thickness of the lower uterine segment was measured with ophthalmic calipers. There were 4 false negative results (4/83: 4.8%) and 1 false positive result (1/43: 2.3%) with conventional ultrasound and no false positives or false negatives with the new method.
在孕晚期，采用传统方法（检查175条瘢痕）和新方法（检查41条瘢痕）对216条剖宫产横切口瘢痕进行了超声检查。新方法包括用传统方法以及3M探头进行经腹纵扫、经腹 frontal 扫以获得瘢痕的表面图像，以及经会阴和经阴道纵扫。新方法从妊娠16周起开始使用。在采用新方法检查的41条瘢痕中，31条显示愈合良好，全程厚度超过2毫米；10条瘢痕愈合不佳，厚度小于2毫米且连续性中断。在31例愈合良好的患者中，8例经阴道分娩，其余23例因其他产科指征行再次剖宫产。所有超声显示愈合不佳的患者均行再次剖宫产。术中用眼科卡尺测量子宫下段厚度。传统超声检查有4例假阴性结果（4/83：4.8%）和1例假阳性结果（1/43：2.3%），而新方法无假阳性或假阴性结果。
