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首页> 外文期刊>Journal of Clinical Ultrasound: JCU >Measurements of the lower uterine segment during gestation
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Measurements of the lower uterine segment during gestation

机译：妊娠期间子宫下段的测量

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Purpose: To establish normal values for the lower uterine segment (LUS) thickness and to recognize factors that may affect these values. Methods:: In this cross-sectional study, we measured the LUS thickness in women between 11 and 41 weeks gestation. Women with placental abnormalities and fetal anomalies were excluded. Fetal weight, location of placental implantation, and cervical length were estimated. The LUS was examined to identify the thinnest zone and evaluated using the transvaginal approach with an empty urinary bladder. Full LUS thickness was measured with a caliper at the inner surface of the posterior bladder wall and another caliper at the interface between the amniotic fluid and the decidua. The myometrium was measured with the first caliper at the interface between the amniotic fluid and the deciduas and the second between the bladder wall and the myometrium. Normal values for the LUS were established throughout gestation, and correlations between the LUS gestational age, fetal weight, previous cesarean section, and other parameters were examined. Results:: Overall, 350 women were included in our study. Median parity was 1 (0-6) and the majority (62%, 218/350) of women have not had a previous cesarean section. The LUS thickness inversely correlated with gestational week (Pearson's r = -0.11, p 0.03). When stratifying the linear regression model to women with and without a history of a previous cesarean section, it was demonstrated that gestational age was moderately correlated with LUS only in the second group of patients (Pearson's r = -0.16, p = 0.1 and Pearson's r = -0.47, p 0.0001, respectively). During the post term period, patients who had had a previous cesarean section had significantly thinner LUS compared with patients who had not had a previous cesarean section (46 mm ± 20 versus 59 mm ± 20, p = 0.002, respectively). Neither parity nor the number of previous cesarean sections were found to correlate with the thickness of the LUS (p 0.05). Multivariate linear regression (R2 = 0.215, F(2, 63) = 9.021, p 0.001) demonstrated that both gestational week (β = -0.13, p 0.04) and cesarean section (β = -0.01, p 0.0001) were independent factors associated with the thickness of the LUS; for every 1 week increase in gestational week, there was a 1.3 mm decrease in the total thickness of the LUS Conclusions:: We have established reference ranges for LUS thickness throughout gestation. The LUS thickness decreases throughout gestation in singleton pregnancies and is significantly thinner in postterm period pregnant women with a previous cesarean section.
机译：目的：为下子宫节（LUS）厚度建立正常值，并识别可能影响这些值的因素。方法：在这项横断面研究中，我们测量了妊娠11至41周之间女性的LUS厚度。排除胎盘异常和胎儿异常的女性。估计胎儿体重，胎盘植入位置和宫颈长度。检查LUS以确定最薄的区域，并使用经阴道入路和空膀胱进行评估。用膀胱后壁内表面的卡尺和羊水与蜕膜之间界面的另一卡尺测量LUS的全部厚度。用第一个卡尺在羊水和蜕皮之间的界面上测量第二个卡尺，在膀胱壁和子宫肌层之间使用第二个卡尺来测量。在整个妊娠过程中建立LUS的正常值，并检查LUS胎龄，胎儿体重，先前的剖宫产和其他参数之间的相关性。结果：总共有350名女性参与了我们的研究。中位数是1（0-6），并且大多数（62％，218/350）女性没有做过剖腹产。 LUS厚度与妊娠周成反比（Pearson r = -0.11，p <0.03）。当对有或没有既往有剖宫产史的女性进行线性回归模型分层时，表明仅在第二组患者中，胎龄与LUS有中等相关性（Pearson's r = -0.16，p = 0.1和Pearson's r分别为-0.47，p <0.0001）。在足月后期，与没有进行剖宫产的患者相比，曾经进行过剖宫产的患者的LUS明显更薄（分别为46 mm±20对59 mm±20，p = 0.002）。胎次和前次剖宫产的数量均未发现与LUS的厚度相关（p> 0.05）。多元线性回归（R2 = 0.215，F（2，63）= 9.021，p <0.001）证明孕周（β= -0.13，p <0.04）和剖宫产（β= -0.01，p <0.0001）均与LUS厚度有关的独立因素;妊娠周每增加1周，LUS的总厚度就会减少1.3毫米。结论：：我们为整个妊娠建立了LUS厚度的参考范围。在单胎妊娠中，LUS的厚度在整个妊娠期都会降低，而在先前剖宫产的孕妇中，LUS的厚度会明显变薄。

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