Comparative Study of Ultrasound Signs of Scar Pregnancy in Patients with Cesarean Section and Their Clinical Outcomes

Abstract

Caesarean scar pregnancy is the implantation of fertilized eggs in the scar of the previous cesarean section in the lower uterus. It is a serious long-term complication after cesarean section. Ultrasound examination, as the first choice to evaluate cesarean scar pregnancy plays an important role in its diagnosis, treatment and follow-up. This study first tried to propose new ultrasound diagnostic indicators to distinguish cesarean scar pregnancy from non-scar pregnancy of the lower uterine cavity; Logistic regression analysis was used to screen for risk factors related to scar pregnancy bleeding, with a view to providing clinical ultrasound indicators to predict bleeding risk; Secondly, the use of contrast-enhanced ultrasound and three-dimensional ultrasound to observe the scar diverticulum of cesarean section more than six months after the different surgical treatments of scar pregnancy, and to evaluate whether surgical scar repair can improve the scar diverticulum. Finally, using ultrasound to predict the position of the embryonic placenta, the new type of scar pregnancy in cesarean section is divided into three types: anterior wall placenta, anterior wall posterior placenta and posterior wall placental. The three types of CSP have significant differences in the thickness of the muscular layer in the scar of the lower part of the anterior wall of the uterus, the blood flow in the scar of the lower part of the anterior wall of the uterus, the number of days of hospitalization, the treatment method, and the treatment effect, which indicate that the new type is used for the diagnosis of CSP. Treatment and prognosis evaluation have high clinical value, can be used to guide clinical work, and provide a new idea for clinical diagnosis and treatment.

Clinical Utility of the Prenatal Ultrasound Score of the Placenta Combined with Magnetic Resonance Imaging in Diagnosis of Placenta Accreta during the Second and Third Trimester of Pregnancy

“…By conducting analysis from a theoretical point of view, it is found that factors capable of triggering primary decidual dysgenesis or secondary endometrial damage, such as adenomyosis, uterine malformation, induced abortion, and endometrial infection, may cause placenta accreta. Based on the findings of relevant studies at home and abroad [ 12 – 14 ], it is generally believed that advanced maternal age, cesarean delivery, induced abortion, placenta praevia, and history of uterine surgery are high-risk factors for triggering placenta accreta, of which placenta praevia and cesarean delivery are the most significant, while advanced maternal age and placenta praevia are considered to be two independent risk factors for placenta accreta. Among 108 patients with suspected placenta accreta, 75 with pathologically confirmed placenta accreta were included in the accreta group, and 33 without placenta accreta were included in the non-accreta group; no statistical between-group differences in patients' age, gestational weeks, educational degree, and other general data were observed ( P > 0.05), but the history of cesarean section, history of induced abortion, and the incidence rate of placenta praevia were significantly higher in the accreta group than in the non-accreta group ( P < 0.05).…”