Value of intraluminal three-dimensional ultrasound combined with clinical indicators on abnormal uterine bleeding caused by uterine incision diverticulum after cesarean section
XIAO Li
QI Huili
HONG Lei
XU Sha
WANG Jixiang
ZHANG Liangliang
Abstract：Objective To explore the value of three-dimensional ultrasound combined with clinical indicators in uterine incision diverticulum after cesarean section.Methods From January 2017 to April 2023,the data of 126 patients with uterine incision diverticulum after cesarean section who underwent vaginal ultrasound examination in Shihezi People's Hospital were collected.According to the bleeding after cesarean section,the patients were divided into group 1(no abnormal bleeding,n= 72)and group 2(abnormal bleeding,n=54).All patients underwent vaginal ultrasound(two-dimensional ultrasound and three-dimensional ultrasound)examination.The clinical characteristics(uterine location,cesarean section frequency,cesarean section suture method,etc.)To establish a prediction model based on clinical and ultrasound characteristics,to explore independent risk factors for abnormal uterine bleeding in patients with uterine incision diverticulum after cesarean section,and to evaluate the predictive value of this model.Results There were statistically significant differences in the number of cesarean sections,uterine position,endometrial thickness,diverticulum depth,diverticulum length,diverticulum volume,diverticulum ratio,and residual base layer thickness between the two groups(P<0.05),multivariate regression analysis showed that uterine location,cesarean section frequency,diverticulum volume,diverticulum ratio and residual muscle thickness were independent risk factors for abnormal uterine bleeding(OR=0.087,10.385,4.658,12.892,0.001,P<0.05),compared with each single factor,the AUC of this model for predicting abnormal uterine bleeding was 0.936,which was significantly higher than each single factor(AUC=0.567,0.705,0.836,0.895,0.870,P<0.05).When-6.28 was the cut-off value,the sensitivity was 87.04%,the specificity was 91.67%,and the accuracy was 89.68%,which was in good agreement with the clinical diagnosis results(Kappa=0.789,P<0.001).Conclusion Uterine location,number of cesarean sections,volume of diverticulum,ratio of diverticulum and thickness of residual muscle layer are independent risk factors for uterine incision diverticulum combined with abnormal uterine bleeding after cesarean section.Abnormal uterine bleeding caused by incisional diverticulum has important predictive value.
Keywords：uterine incision diverticulumvaginal three-dimensional ultrasonographycesarean sectionabnormal uterine bleeding
Publication Date：2024-04-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 143-150 )