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| Analysis of the characteristics of caesarean scar pregnancy diagnosed by transvaginal color Doppler ultrasonography and its diagnostic efficiency |
| Dezhou Women and Children's Hospital, Shandong Province, 253000 |
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Abstract To explore the characteristics of caesarean scar pregnancy diagnosed by transvaginal color Doppler ultrasonography, and to study the diagnostic value of transvaginal color Doppler ultrasonography. Methods: A total of 198 patients with uterine scar pregnancy diagnosed by transvaginal color Doppler ultrasonography and confirmed by clinical surgery were selected in this study from December 2016 to December 2020. The characteristics of uterine scar pregnancy diagnosed by transvaginal color Doppler ultrasonography were analyzed. The value of transvaginal color Doppler ultrasonography for diagnosing caesarean scar pregnancy was analyzed by receiver operating characteristics（ROC) curve. Results: Scar pregnancy of pregnancy sac type had showed the pregnancy sac at cesarean section incision, yolk sacs could be found in the pregnancy sacs, the original heart tube pulsation and embryo could be found in part of pregnancy sacs, high echo around the pregnancy sacs and the thinning uterine wall of the local pregnancy sac could be found, and the abnormal increased blood flow in the lower uterine segment could be found by color Doppler flow imaging (CDFI). Scar pregnancy of masses type had showed the heterogeneous echo masses at the incision of cesarean section in the lower segment of uterus, with no obvious capsule and various forms, the central area of the mass was low echo or no echo, and the echo around the mass was unclear, the thinning uterine wall of the local pregnancy sac could be found, the endometrial line of uterine was unclear, and abundant blood flow signals in the lesion area was found by CDFI. In these 198 patients, there were 67 cases with scar pregnancy of pregnancy sac type and 127 cases with scar pregnancy of masses type diagnosed by transvaginal color Doppler ultrasonography. There were 67 cases with scar pregnancy of pregnancy sac type and 131 cases with scar pregnancy of masses type confirmed by clinical operation. There were 4 cases with scar pregnancy of mass type were missed diagnosis by transvaginal color Doppler ultrasonography. The results of clinical operation were as gold standard, the sensitivity, the specificity, and the accuracy of transvaginal color Doppler ultrasound for diagnosing cesarean section scar pregnancy were 98.0% (194/198), 100.0%, and 98.0%, respectively. Area under curve AUC of ROC curve was 0.915 (95%CI: 0.876-0.982). Conclusion: Transvaginal color Doppler ultrasound for diagnosing cesarean scar pregnancy has high sensitivity and accuracy, which can effectively improve the detection rate, so it has some guiding significance for clinical diagnosis and treatment of cesarean scar pregnancy.
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