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| Correlation between the muscular layer thickness of pregnant women with scarred uterus and their adverse pregnancy outcomes |
| Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University (Nanjing Maternal and Child Health Hospital), Nanjing, Jiangsu Province, 210000 |
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Abstract To study the correlation between the muscular layer thickness of pregnant women with scarred uterus and their adverse pregnancy outcomes. Methods: The clinical data of 84 pregnant women with scarred uterus who were diagnosed and treated in hospital from May 2020 to June 2022 were collected. The muscle layer thickness of the women during the second trimester of pregnancy were measured, and the pregnancy outcomes of the women were calculated. The maternal and the neonatal outcomes were compared among the women with different muscle layer thickness, and the correlation between the muscle layer thickness of the women and their adverse pregnancy outcomes was analyzed. Results: The intraoperative blood loss, the incomplete uterine rupture rate, the postpartum hemorrhage rate, the uterine atony rate, the neonatal low body weight rate and the neonatal respiratory disease rate of the women with muscular thickness ≥4mm were significantly lower than those of the women with muscular thickness of 1-4mm (P＜0.05). There were no statistically significant differences in the neonatal body weight and the rate of the neonatal transfer to other department among the three groups (P＞0.05). The rates of >30 years old, the myometrium thickness <4mm, the prenatal BMI≥30kg/m2 and the delivery gestational week > 38 weeks of the women with adverse pregnancy outcomes were significantly higher than those of the women with normal pregnancy outcomes (P＜0.05). There were no statistically significant differences in the education level and the interval from the previous cesarean section of the women between the two groups (P＞0.05). Logistic regression analysis showed that the maternal age >30 years old, the myometrium thickness <4mm, the prenatal BMI≥30kg/m2 and the delivery gestational week >38 weeks of the women were the independent risk factors of their adverse pregnancy outcomes (P＜0.05). Receiver operating characteristic (ROC) curve showed that the area under the curve of the myometrium thickness of the women for predicting their adverse pregnancy outcomes was 0.807 (95%CI: 0.718-0.897). Conclusion: The thin myometrium thickness of the pregnant women with scarred uterus during the second trimester of pregnancy is an independent risk factor of their adverse pregnancy outcomes, and which has some predictive value for the risk of the adverse pregnancy outcomes of the women.
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