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| Value of transvaginal Doppler color ultrasound combined with β-hCG detection for guiding delivery mode of the subseguent re-pregnant after cesarean section |
| The 941 Hospital of Service Support Force, Xining, Qinghai Province,81000 |
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Abstract To explore the value of transvaginal Doppler color ultrasound combined with serum human chorionic gonadotropin (β-hCG) level for diagnosing uterine scar healing. Methods: 140 pregnant women with scar uterus during the third trimester of pregnancy were selected from January 2017 to June 2019. After 35 gestational weeks, these women were given transvaginal Doppler color ultrasound examination and serumβ-hCG detection. The healing situation of scar uterus of these women was judged, and their delivery outcomes were compared. Results: In these 140 women, there were 117 (83.57%) grade I of uterine scar and theβ-hCG level (24335.35±236.51IU/L), 15 (10.71%) women with grade II of uterine scar and theβ-hCG (26456.84±313.57IU/L), 7 (5.00%) women with grade Ⅲ of uterine scar and theβ-hCG level (31467.67±974.51 IU/L), and 1 (0.72%) woman with grade Ⅳ of uterine scar and the β-hCG level (33451.58±1023.49 IU/L). The serum β-hCG level of the women with grade II, Ⅲ, or IV of uterine scar were significant higher than that of the women with grade I of uterine scar (P＜0.05). ROC curve analysis showed that the sensitivity, the specificity, and AUC of transvaginal Doppler color ultrasound combined with β-HCG level for diagnosing scar uterus were 64.6%, 97.2%, and 0.648, respectively. The vaginal delivery of the women with grade I of scar uterus accounted for 80.3%, and their cesarean delivery accounted for 19.7%. The vaginal delivery of the women with grade II of scar uterus accounted for 26.7%, and their cesarean delivery accounted for 73.3%. The cesarean delivery of the women with grade Ⅲ of scar uterus accounted for 100%, and there was 1 woman with grade Ⅳ of scar uterus had chosen cesarean delivery. The rate of cesarean delivery of the women with grade II or Ⅲ of scar uterus was significant higher than that of the women with grade I of scar uterus (P＜0.05). Conclusion: Transvaginal Doppler color ultrasound detection and serum β-hCG level for diagnosing uterine scar healing has good reference value, which can be as evidence for guiding delivery mode of the re-pregnant women with scar uterus.
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