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| Forecast on the Mode of SP Delivery after Cesarean Section by TVS Combined with Real-time Shear Wave Elastography |
| ZHAO Yanyan, NAN Ruixia, WAN Ying, et al |
| The First Affiliated Hospital of Hainan Medical University, Hainan Haikou 570102, China |
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Abstract Objective: To study the predictive value of transvaginal ultrasonography (TVS) combined with real-time shear wave elastography (TVE) on the mode of re delivery of scar pregnancy (SP). Methods: 105 patients with SP pregnancy after cesarean section in our hospital from October 2017 to October 2020 were selected. All patients were examined by TVs with Voluson730 ultrasonic diagnostic instrument, and then real-time shear wave elastography was performed by Mindray Resona 7 ultrasonic diagnostic instrument to observe the thickness of lower uterine muscle layer. The scar grading, delivery outcome and elasticity score were statistically analyzed. Results: The scar development rate of TVS combined with real-time shear wave elastic imaging was 100.00% (105/105)(P<0.05). 79 cases were classified as grade I, 17 cases as grade II, 7 cases as grade III and 2 cases as grade IV. With the increase of scar grade, the thickness of lower uterine segment gradually decreased, and the amount of bleeding increased during cesarean section (P<0.05). Compared with scar grade I, the cesarean section rate and vaginal delivery rate of patients with grade II, grade III and grade IV were lower than those with grade II scar (P<0.05). Compared with cesarean section, vaginal delivery patients had no 3-point elasticity score, 1-point elasticity score was higher, and 2-point elasticity score was lower (P<0.05). Conclusion: Transvaginal TVs combined with real-time shear wave elastography can improve the development of uterine scar, and has an advantage in detecting the thickness of lower uterine muscle layer. The combination of the two methods has a certain predictive value for the choice of delivery mode of SP after cesarean section.
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2021, Vol. 27 
