目的：探究剖宫产后再次妊娠中晚孕期子宫下段的超声表现。方法产检妊娠中晚期孕妇1230例,按妊娠情况分为三组, A组为剖宫产后再次妊娠孕妇430例, B组为初产妇400例, C组为顺产后再次妊娠孕妇400例,对所有孕妇进行子宫下段超声监测与检查,对检查结果进行分析。结果三组子宫下段肌层测量值：A组[(3.5±1.2)mm,20~24周],[(1.8±0.6)mm,>36周]；B组[(4.4±1.5)mm,20~24周],[(2.0±0.5)mm,>36周]；C组[(6.0±1.2)mm,20~24周],[(2.8±0.9)mm,>36周]；A组术前提示肌层消失5例, A组子宫下段肌层测量值低于B组、C组,差异具有统计学意义(P<0.05)；经腹超声检查其瘢痕位置表现为回声增强、肌层边界不清、局部低回声肌层显著变薄；A组所有病例均再次进行剖宫产分娩,术中子宫先兆破裂5例,局部较薄者50例。结论剖宫产后再次妊娠中晚期孕妇行子宫下段超声检查,可及时发现高危因素,具有重要的临床意义。%Objective To explore ultrasound effect of uterine lower segment in metaphase and later period pregnancy again after a caesarean section.Methods A total of 1230 cases of pregnant women were divided into three groups by pregnant condition. Group A contained 430 cases of re-pregnant women after caesarean, 400 cases of primipara were in group B, and 400 cases of re-pregnant after natural labour were in group C. All cases were given lower uterine segment ultrasound monitoring and inspection, and the inspection results were analyzed.Results The lower uterine segment muscular layer measured values of the three groups were as followed: group A [(3.5±1.2) mm, 20~24 weeks] [(1.8±0.6) mm, >36 weeks]; group B [(4.4±1.5) mm, 20~24 weeks] [(2.0±0.5) mm, >36 weeks]; group C [(6.0±1.2) mm, 20~24 weeks] [(2.8±0.9) mm, >36 weeks]. There were 5 cases of muscular disappear before surgery in group A. Uterine segment measurement values of group A were significantly lower than group B and group C, and the difference was statistically significant (P<0.05). Transabdominal ultrasonography showed scar location was echogenic, muscle ill-defined, hypoechoic myometrium significant local thinning. All cases in group A were performed caesarean delivery, and there were 5 cases of uterine surgery threatened rupture and 50 cases of local thin.Conclusion Ultrasound examination of uterine lower segment metaphase and later period pregnancy again after a caesarean section can timely detect risk factors, and has important clinical significance.
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