Doğru Şükran, Ezveci Huriye, Akkuş Fatih, Yaman Fikriye Karanfil, Alp Elifsena Canan, Gezginç Kazim
Department of Obstetrics and Gynecology, Division of Perinatology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey.
Department of Obstetrics and Gynecology, Necmettin Erbakan Univercity, Meram School of Medicine, Konya, Turkey.
J Ultrason. 2024 Dec 23;24(99):1-7. doi: 10.15557/jou.2024.0035. eCollection 2024 Dec.
This study aimed to evaluate the effects of diabetes mellitus and cervical dilatation on cesarean section scar healing.
This prospective study included pregnant women diagnosed with diabetes mellitus and healthy control pregnant women. The study group was divided into active labor and pre-active labor based on cervical dilatation, and the diabetic group was categorized into gestational diabetes and preexisting diabetes mellitus. Vaginal ultrasound was performed in the entire study group at six months postpartum, and the location of the cesarean scar was evaluated.
There were 170 participants in the study; 85 were diabetic, and the remaining 85 were healthy controls. Niche frequency in diabetes mellitus cases was not different from that in healthy controls ( = 0.420). The mean residual myometrial thickness, proximal residual myometrial thickness, and distal residual myometrial thickness were lower in the diabetic group ( = 0.001). Residual myometrial thickness and niche presence in the diabetic group with active labor was not statistically different from the diabetic group without active labor ( >0.05). Additionally, residual myometrial thickness was thinner in the gestational diabetes mellitus group than in the preexisting diabetes mellitus group (3.61 ± 1.78 mm vs. 4.76 ± 2.82 mm, = 0.032).
There was no significant difference in niche frequency between diabetic cases and healthy controls. When comparing the gestational diabetes mellitus group and the preexisting diabetes mellitus groups, there was no difference in the presence of niches. Niche presence was more common in diet-regulated diabetic patients compared with the insulin-regulated group. Cervical dilatation at the time of cesarean section did not affect niche presence in diabetic cases.
本研究旨在评估糖尿病和宫颈扩张对剖宫产瘢痕愈合的影响。
这项前瞻性研究纳入了被诊断为糖尿病的孕妇和健康对照孕妇。研究组根据宫颈扩张情况分为活跃期分娩组和分娩前期组，糖尿病组又分为妊娠期糖尿病组和孕前糖尿病组。在产后6个月对整个研究组进行经阴道超声检查，评估剖宫产瘢痕的位置。
本研究共有170名参与者；其中85名患有糖尿病，其余85名是健康对照者。糖尿病患者的切口憩室发生率与健康对照者无差异（P = 0.420）。糖尿病组的平均子宫肌层残余厚度、近端子宫肌层残余厚度和远端子宫肌层残余厚度较低（P = 0.001）。活跃期分娩的糖尿病组与未活跃期分娩的糖尿病组在子宫肌层残余厚度和切口憩室存在情况方面无统计学差异（P>0.05）。此外，妊娠期糖尿病组的子宫肌层残余厚度比孕前糖尿病组更薄（3.61±1.78毫米对4.76±2.82毫米，P = 0.032）。
糖尿病患者与健康对照者在切口憩室发生率上无显著差异。比较妊娠期糖尿病组和孕前糖尿病组，切口憩室的存在情况无差异。与胰岛素治疗组相比，饮食控制的糖尿病患者中切口憩室的存在更为常见。剖宫产时的宫颈扩张对糖尿病患者的切口憩室存在情况无影响。
