The Diagnostic Value And Related Factors Analysis Of Transvaginal Ultrasound For Early Formation Of Cesarean Incision Diverticulum

Objective:This study was designed to evaluate the diagnostic value and risk factors of the early formation of previous cesarean scar defect(P CSD) by transvaginal sonography(TVS).Methods:Collected 190 cases of women patients who had strictly indications of cesarean section and observed uterine incision ultrasonography characteristics after postpartum 42 days (190 cases of early group),6 months (100 cases of six months group) respectively for TVS. Measured the width, depth, remain myometrium thickness(RMT) of the defect of uterine incision in different periods. Observed the development process of sonographer of suspicious PCSD changed to PCSD.Results:1、Ultrasonographic features of uterine incision in early a nd six months group:86 cases recovered well (45.2%),46 cases uterine i ncision were hypoechoic or mixed but were not interlinked to uterine cavi ty (24.2%), and 58 cases were interlinked to uterine cavity(30.6%).55 cas es returned to normal (55%),25 cases incision were hypoechoic and not i nterlinked to uterine cavity (25%), and the number of formation PCSD w ere 20 cases(20%) in six months incision group.2、100 people were chec ked in two group, three kinds of incision in early group had 25 cases,43 cases,32 cases respectively, and the number of formation PCSD was 20 cases after six months, which respectively accounted for 0.0%(0/20),15. 0%(3/20),85.0%(17/20). Compared to the women who uterus incision was not interlinked to uterine cavity in postpartum early period, scar interlink ed to uterine cavity had a higher risk for formation of PCSD in six mont hs(P<0.05).The suspicious PCSD in early group compared with PCSD in half year group, the width and depth of uterine incision were changed, b ut the RMTwas no significant difference (P<0.05); the shape of PCSD h ad semicircular and triangle, and accounted for 15 cases and 5 case respe ctively.3、Compared to the normal cesarean section group, the related ind ications ofcesarean section, such as cesarean section number, placenta, hyp ertensive disorder complicating pregnancy(HDCP), gestational diabetes mell itus (GDM),abnormal labor, advanced maternal age, premature rupture of membranes group seem to have a higher risk suffering PCSD(P<0.05). 4、Compared to normal lochia time and regular menstruation, prolonged 1 ochia andirregular menstruation tend to have the high occurrence rate of P CSD (P<0.05)Conclusion:TVS examination is a good repeatability and convenience evaluation imaging method to observe the changes of uterine incision after cesarean section in different periods. Ultrasound examination showed that uterine incision poor recovery or incision were hypoechoic or mixed and interlinked to uterine cavity cannot be diagnosed to the formation of PCSD, but could indicate the high occurrence rate of PCSD. The formation of PCSD had a variety of factors, and it usually accompany with some negative effects, such as prolonged lochia and irregular menstruation.