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| Analysis of uterine ultrasound manifestations and the risk factors of scar diverticulum formation of women during different periods after cesarean section |
| The Second Affiliated Hospital of Bengbu Medical College, Anhui Province, 233000 |
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Abstract To investigate the uterine ultrasound manifestations of women during different periods after cesarean section, and to analyze the influencing factors of their uterine scar diverticulum formation. Methods: 78 women after cesarean section were selected as the research objects, and they were all given vaginal ultrasound examination in 1 month, 3 months and 6 months after cesarean section. These women were divided into group A (58 women with good heal of uterine scar) and group B（20 women with uterine diverticulum). The changes of uterine ultrasound images of the women during different period after cesarean section were compared between the two groups. And combined with clinical data of the women with uterine scar diverticulum, the related influencing factors of uterine scar diverticulum formation were analyzed. Results: There were no significant different in the changes of the uterine length, width, and thickness of the women in 1, 3, and 6 months after cesarean section between the two groups (P>0.05). The ultrasonic characteristics of uterine scar of the women in group A mainly included the scar echo uniformly, the continuous and complete of uterine muscle layer incision without obvious defect, and the strong echo of uterine incision suture in some women. The ultrasonic manifestations of uterine scar of the women in group B were mainly the diverticulum with low echo or no echo, the thin and broken muscle layer at the incision, and the continuous and complete of the serosal layer without peripheral blood flow signal. The percentage of scar diverticulum of triangular was mainly 65.0%, and followed by that (20.0%) of the scar diverticulum of wedgeshaped. There were significant differences in the length, width, and depth of scar diverticulum of the women during different periods after cesarean section (P<0.05), but there were no significant differences in the residual muscle thickness and the distance between diverticulum and cervical endostoma (P>0.05). Multivariate analysis showed that the times of cesarean sections, the distance between incision diverticulum and cervical endostoma, the experience of the operator, the puerperal infection, the uterine position of the women were the influential factors of the scar diverticulum formation (P<0.05). Conclusion: The main ultrasonographic manifestations of uterine scar diverticulum after cesarean section of the women are the thinning of myometrium, the complete serosa layer, the hypoechoic or anechoic myometrial defect without obvious blood flow signal around. The size of scar diverticulum of the women decreases with the prolongation of postoperative time gradually. The scar diverticulum formation is mainly affected by the times of cesarean section, the experiences of the operator, the puerperal infection, the uterine posterior position, and other factors.
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