疤痕子宫再妊娠经阴道分娩的影响因素及预测价值分析

doi:10.3969/j.issn.1006-6233.2024.04.022

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Abstract Objective: To investigate the influencing factors and predictive value of vaginal delivery in scarred uterus re-pregnancy. Methods: A retrospective study was conducted on 109 pregnant women with scarred uterus re-pregnancy who were admitted to the First People's Hospital of Bengbu from January 2021 to June 2023. According to the delivery outcome, they were divided into two groups: vaginal delivery success group (n=78) and failure group (n=31). The baseline data and late pregnancy myometrial thickness of the pregnant women in the two groups were compared. Logistic regression analysis was used to analyze the influencing factors of vaginal delivery in scarred uterus re-pregnancy, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of the influencing factors for vaginal delivery in scarred uterus re-pregnancy. Results: There was no significant difference in age, gestational week, parity, interval from previous cesarean section, estimated fetal weight before delivery, admission in labor, and education level between the two groups (P>0.05). The pre-pregnancy body mass index (BMI), cervical Bishop score, and myometrial thickness were significantly different between the two groups (P<0.05). Logistic regression analysis showed that pre-pregnancy BMI, cervical Bishop score, and myometrial thickness were the influencing factors of delivery outcome in scarred uterus re-pregnancy (P<0.05). The ROC curve analysis showed that the areas under the curve (AUC) of pre-pregnancy BMI, cervical Bishop score, and myometrial thickness for predicting vaginal delivery in scarred uterus re-pregnancy were 0.669, 0.691, and 0.670, respectively. The AUC of the combined prediction of the three indicators was 0.806, which was significantly higher than that of the single indicators (Z=2.885, 3.604, 3.296, P=0.004, <0.001, 0.001). The sensitivity was 90.32%, and the specificity was 61.54%. Conclusion: Pre-pregnancy BMI, cervical Bishop score, and myometrial thickness are the influencing factors of vaginal delivery outcome in scarred uterus re-pregnancy and can be used as predictive indicators of vaginal delivery outcome.

Key words： Scared uterus Vaginal delivery Influencing factor Prenatal body mass index Myometrial thickness

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.04.022 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I4/646

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