JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2016, Vol. 54 ›› Issue (5): 39-44.doi: 10.6040/j.issn.1671-7554.0.2015.924

Previous Articles     Next Articles

Early ultrasound observation of uterine incision defect after cesarean section and analysis of related factors

WANG Yihua1, MA Lin1, KAN Yanmin1, WANG Wentao2   

  1. 1. Department of Ultrasound, Affiliated Hospital of North China University of Science and Technology, Tangshan 063000, Hebei, China;
    2. Qinhuangdao Center for Disease Control and Prevention, Qinhuangdao 066000, Hebei, China
  • Received:2015-09-26 Online:2016-05-16 Published:2016-05-16

Abstract: Objective To observe the early changes of uterine incision defect after cesarean section by transvaginal ultrasonography and to analyze the risk factors. Methods A total of 181 maternal cases receiving cesarean section during Sept. 2013 and June 2015, who were examined by transvaginal ultrasound 6 weeks, 3 months, and 6 months postpartum, were divided into 2 groups according to the healing of the incision:good healing group(n=142)and incision defect group(n=39). The changes of the incision in different postpartum periods were observed and the risk factors were analyzed. Results The length of incision 6 months postpartum was shorter than that 6 weeks postpartum(P<0.05). Non-conditional logistic regression analysis showed that an increase in the number of cesarean section, surgeon with low seniority, postoperative infection, posterior uterine and incision close to the cervix were risk factors of incision defect. Conclusion The length of cesarean incision defect shortens as time goes on. Repeated cesarean section, puerperal infection, retroflexed uterine, low-cut position and inexperienced surgeon are risk factors for uterine incision defects, which increase the abnormal healing of uterine scar.

Key words: Cesarean section, Logistic regression, Uterine incision defect, Transvaginal ultrasound, Risk factors

CLC Number: 

  • R445.1
[1] 陈蔚琳, 金力. 剖宫产术后子宫瘢痕缺损及再次妊娠的风险评估[J]. 中华妇产科杂志, 2015, 50(9):718-720. CHEN Weilin, JIN Li. Risk assessment of cesarean scar defect and re-pregnant [J]. Chinese Journal of Obstetrics and Gynecology, 2015, 50(9):718-720.
[2] 李康宁, 戴晴. 超声在剖宫产瘢痕评估中的临床应用[J/CD]. 中华医学超声杂志, 2014, 11(4):307-310. LI Kangning, DAI Qing. The clinical application of ultrasound in the evaluation of scar formation in cesarean section [J/CD]. Chinese Journal of Medical Ultrasound, 2014, 11(4):307-310.
[3] 吴珍珍. 剖宫产后瘢痕缺陷的诊治进展[J]. 现代妇产科进展, 2013, 22(12):1004-1006. WU Zhenzhen. Progress in diagnosis and treatment of cesarean scar defect [J]. Progress in Obstetrics and Gynecology, 2013, 22(12):1004-1006.
[4] 陈诚. 子宫体部手术后不良瘢痕形成的预防措施研究进展综述[J]. 重庆医学, 2013, 42(12):1419-1421. CHEN Cheng. Progress in the prevention of bad scar formation after operation of uterine body [J]. Chongqing Medicine, 2013, 42(12):1419-1421.
[5] 刘杰, 王敬云. 疤痕子宫妊娠的引产与催产[J]. 中国实用妇科与产科杂志, 2002, 18(5):268-270. LIU Jie, WANG Jingyun. Induced labor and oxytocin in the uterine scar pregnancy [J]. Chinese Journal of Parctical Gynecology and Obstetrics, 2002, 18(5):268-270.
[6] Bij de Vaate AJ, van der Voet LF, Naji O, et al. Prevalence, potential risk factors for development and symptoms related to the presence of uterine niches following Cesarean section:systematic review[J]. Ultrasound Obstet Gynecol, 2014, 43(4):372-382.
[7] Pomorski M, Fuchs T, Zimmer M. Prediction of uterine dehiscence using ultrasonographic parameters of cesarean section scar in the nonpregnant uterus: a prospective observational study[J]. BMC Pregnancy Childbirth, 2014, 14:365. doi: 10.1186/s12884-014-0365-3.
[8] Vikhareva Osser O, Valentin L. Clinical importance of appearance of cesarean hysterotomy scar at transvaginal ultrasonography in nonpregnant women[J]. Obstet Gynecol, 2011, 117(3):525-532.
[9] Gasim T, Al Jama FE, Rahman MS, et al. Multiple repeat cesarean sections:operative difficulties, maternal complications and outcome [J]. J Reprod Med, 2013, 58(7-8):312-318.
[10] Gubbini G, Casadio P, Marra E. Resectoscopic correction of the “isthmocele” in women with postmenstrual abnormal uterine bleeding and secondary infertility [J]. J Minim Invasive Gynecol, 2008, 15(2):172-175.
[11] 阎淑丽. 剖宫产术后42天子宫切口愈合不良的讨论分析[J]. 中国医药指南, 2013, 11(23):201. YAN Shuli. Discussion and analysis of uterine incision abnormal healing after 42 days postpartum[J]. Guide of China Medicine, 2013, 11(23):201.
[12] Osser OV, Jokubkiene L, Valentin L. High prevalence of defects in Cesarean section scars at transvaginal ultrasound examination[J]. Ultrasound Obstet Gynecol, 2009, 34(1):90-97.
[13] Wang CB, Chiu WW, Lee CY, et al. Cesarean scar defect:correlation between Cesarean section number, defect size, clinical symptoms and uterine position [J]. Ultrasound Obstet Gynecol, 2009, 34(1):85-89.
[14] 苏冠男, 王武亮, 袁博, 等. 子宫切口瘢痕憩室形成的相关因素研究[J]. 中国全科医学, 2015, 18(4):421-424. SU Guannan, WANG Wuliang, YUAN Bo, et al. Related factors in the formation of previous cesarean scar defect[J]. Chinese General Practice, 2015, 18(4):421-424.
[1] GONG Zhuo, ZHANG Minmin, WANG Zhiping. Influence of abortion and family heredity history on the risk of uterine leiomyomas [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(9): 100-104.
[2] SUN Qijing, CHEN Fangfang, LI Chunxiao, ZHANG Caiqing. Clinical value of PNI and HGB in evaluating the prognosis of the middle to late stage non-small cell lung cancer patients [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(4): 55-59.
[3] LI Xiaoying, LIU Fang, CHE Haijie, ZHANG Jinhui. Establishment and preliminary evaluation of a model for predicting the malignant probability of solitary pulmonary nodule with tumor markers [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(4): 60-64.
[4] WANG Yongqiang, ZHANG Weiquan, SUN Qifeng, DONG Xiaopeng, PENG Chuanliang, ZHANG Yuan, ZHAO Xiaogang. Expression and significance of CK14 in non-small cell lung cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(3): 83-87.
[5] DU Heng, YUAN Xiaodong. Progress in the etiology and pathogenesis of Alzheimers disease [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(10): 21-27.
[6] QIU Chengxuan, DU Yifeng. A call for action to strengthen research on population interventions against Alzheimers disease and senile dementia [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(10): 1-6.
[7] SHANG Jianqiang. Role of intravascular interventional therapy in cesarean section for pernicious placenta previa complicated with placenta accreta [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(9): 14-17.
[8] LI Jijun, ZUO Changting, WANG Xietong, SHANG Jianqiang. Application of abdominal aorta balloon occlusion in cesarean section for patients with pernicious placenta previa complicated by placenta accreta [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(9): 22-25.
[9] HONG Haijie, SUN Wenjuan, ZHANG Yuan, XU Yongping. Influencing factors of adverse outcomesin term neonates delivered by elective caesarean [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(5): 56-61.
[10] DING Juan, ZHENG Guixi, DU Lutao, YIN Zuohua, ZHANG Jian, WANG Chuanxin. Evaluation of combined detection of sHLA-G, PGR and GPR in the diagnosis of gastric cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(11): 59-63.
[11] HUANG An-cui, TIAN Wei-yun. Application of strap-uterine suture in caesarean postpartum hemorrhage [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(S1): 43-44.
[12] ZHANG Ying, CHEN Hongmei, WU Xinyi. Prevalence and risk factors of dry eye syndrome in senior high school students in Shouguang City of Shandong Province, China [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(3): 82-85.
[13] LI Jianzhuo, JIN Yan, YANG Hui, LI Xinrui, HU Yanxia, ZHANG Changqing, ZHU Yanwen, RUAN Shiman. Influencing factors of drug treatment compliance among patients with HIV/AIDS in Jinan city of China [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(3): 106-110.
[14] CHANG Xue-run1,2, SUN Xiu-bin1, LIU Yan-xun1, YUAN Zhong-shang1, ZHANG Jing-xuan2, XUE Fu-zhong1. Prevalence of depression symptoms and its risk factors in the rural residents of Laiwu City [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(7): 96-99.
[15] FENG Fei1, YAN Jin2, YUAN Ping1, HU Xiao-qin1, XU Lin2, YANG Yan-fang1. Relationships between dietary, lifestyle and colorectal cancer: a matched casecontrol study [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(7): 107-112.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!