Correlation analysis of ultrasound combined with abdominal wall scar score and abdominal adhesion in pregnant women during repeat cesarean section
Objective To analyze the correlation between ultrasound combined with abdominal wall scar score and abdominal adhesion in pregnant women during repeat cesarean section.Methods A total of 270 pregnant women who underwent repeat cesarean section in West China Guang'an Hospital of Sichuan University from January 2020 to December 2022 were selected,including 185 women without or with mild abdominal adhesion(no/mild adhesion group)and 85 women moderate/severe abdominal adhesion(moderate/severe adhesion group).They were examined with ultrasound and the ultrasonic sliding distance was calculated.The Manchester Scar Scale(MSS)was used to score abdominal wall scars.Logistic regression analysis was performed to screen the risk factors for abdominal adhesion in pregnant women during repeat cesarean section,and the regression model was determined according to the risk value.The ROC curve was used to analyze the value of this model in predicting abdominal adhesion in pregnant women during repeat cesarean section.Results The scores for appearance,contour,deformation and texture,and the total MSS score in moderate/severe adhesion group were higher than those in no/mild adhesion group(P＜0.05),but there was no significant difference in color scores between the two groups(P＞0.05).The ultrasonic sliding distance in moderate/severe adhesion group was shorter than that in no/mild adhesion group(P＜0.05).Logistic multivariate regression analysis showed that the appearance,contour and texture of abdominal wall scar were risk factors for abdominal adhesion during repeat cesarean section,and the ultrasonic sliding distance was a protective factor(P＜0.05).A model was condtructed based on the factors with statistically significant differences in univariate analysis,the prediction probability was calculated,and the ROC curve was drawn.The area under the curve(AUC),sensitivity and specificity were 0.908,85.00％and 90.00％,indicating that the prediction model had high accuracy for predicting abdominal adhesion during repeat cesarean section.Conclusions The ultrasonic sliding distance and abdominal wall scar score are influencing factors of abdominal adhesion during repeat cesarean section.Ultrasound combined with abdominal wall scar score is of high value in predicting abdominal adhesion during repeat cesarean section.
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