Application of frequency ultrasound in trial of labor after cesarean
ZHONG Wan
CHEN Zhen-yu
LYU Xiu-zhi
LI Juan
JIN Jia-xi
LI Yue
Abstract：Objective To explore the feasibility of using ultrasound monitoring of the lower uterine segment during labor in trial of labor after cesarean(TOLAC).Methods A total of 164 multiparous women who met the criteria for TOLAC and requested TOLAC were selected from the General Hospital of Northern Theater Command from July 2021 to December 2023 as the TOLAC group,aged(33.04±4.56)years old,ranging from 23 to 42 years old.Another 164 primiparous women who underwent vaginal trial of labor during the same period were selected as the control group,aged(32.70±4.38)years old,ranging from 23 to 42 years old.Both groups underwent high-frequency ultrasound measurement of the lower uterine segment muscle thickness during labor.The delivery outcomes and maternal and neonatal outcomes were compared between the two groups.The thickness of the lower uterine segment muscle during and between contractions was measured and compared in the successful delivery cases of both groups.The thickness of the lower uterine segment muscle during contractions in different stages of labor was also compared between the successful delivery cases of both groups.Results There were no statistically significant differences between the TOLAC group and the control group in terms of postpartum blood loss,postpartum hemorrhage rate,neonatal weight,neonatal Apgar score,and neonatal admission to the intensive care unit(P＞0.05).The TOLAC group had a lower rate of successful vaginal delivery and shorter gestational weeks compared with the control group(P＜0.05).In both groups,the thickness of the lower uterine segment muscle during contractions was significantly less than that between contractions in successful delivery cases(P＜0.05).There was no statistically significant difference in the change of lower uterine segment muscle thickness during and between contractions between the successful delivery cases of the TOLAC group and the control group(P＞0.05).In the TOLAC group,the thickness of the lower uterine segment muscle was significantly different during the latent phase,active phase,and second stage of labor in successful delivery cases(P＜0.05).Similarly,in the control group,the thickness of the lower uterine segment muscle was significantly different during the latent phase,active phase,and second stage of labor in successful delivery cases(P＜0.05).The thickness of the lower uterine segment muscle during the latent phase,active phase,and second stage of labor was significantly lower in the successful delivery cases of the TOLAC group compared with the control group(P＜0.05).Conclusion High-frequency transabdominal ultrasound can be used to dynamically monitor the lower uterine segment during TOLAC and can help identify women with poor uterine scar healing in advance.
Keywords：Vaginal birth after cesareanLower uterine segmentHigh frequency ultrasoundLabor
Publication Date：2025-07-25
Online Publishing Date：2025-08-26(First online date of this platform, not the publication date of the document)
Pages：5( 261-265 )