Effect of residual muscle thickness and scar thickness on re-intervention of scar pregnancy patients with curettage
Objective To analyze the effect of residual muscle thickness and scar thickness on re-intervention of scar pregnancy patients with curettage.Methods A total of 86 pregnant patients with cicatricial cesarean section scars who were admitted to Baoding Maternal and Child Health Hospital from May 2020 to May 2022 and received ultrasound-guided curettage were selected as the study objects.According to whether the patients were re-intervened after surgery,they were divided into re-intervention group(n=32)and no re-intervention group(n=54).Magnetic resonance imaging(MRI)was performed on admission of all patients.The residual muscle thickness,scar thickness,normal muscle thickness adjacent to lesion and embryo size of the two groups were compared,and the relationship between the residual muscle thickness,scar thickness and embryo size on re-intervention of scar pregnancy patients with curettage was analyzed by Logistic regression analysis.The receiver operating characteristic(ROC)curve was plotted to evaluate its predictive value for re-intervention in scar pregnancy patients with curettage.Results The residual muscle thickness and scar thickness in the re-intervention group were lower than those in the no re-intervention group(P＜0.05),while the embryo size was higher than that in the no re-intervention group(P＜0.05).Multivariate Logistic regression analysis showed that the residual muscle thickness ≤2.89 mm(OR=2.063,95％CI:1.249-3.407),scar thickness ≤3.27 mm(OR=1.893,95％CI:1.122-3.194)and embryo size＞2.69 cm(OR=2.787,95％CI:1.406-5.524)were important influencing factors for re-intervention in scar pregnancy patients with curettage(OR＞1,P＜0.05).ROC curve results showed that when the optimal cut-off values of residual muscle thickness and scar thickness were 2.89 mm and 3.27 mm,the area under curve(AUC)for predicting re-intervention of scar pregnancy patients with curettage was 0.73(95％CI:0.678-0.812)and 0.75(95％CI:0.704-0.825),the sensitivity and specificity were 76.48％,78.39％and 70.32％,70.33％,respectively.The AUC of the combined prediction for re-intervention in scar pregnancy patients with curettage was 0.81(95％CI:0.746-0.859),and the sensitivity and specificity were 82.37％and 71.42％,respectively.Conclusions The reductions of residual muscle thickness and scar thickness are important factors affecting the re-intervention of scar pregnancy patients with curettage.The combination of the two indicators has an important value in predicting the re-intervention of scar pregnancy patients with curettage.
Residual muscle thicknessScar thicknessScar pregnancy with curettagePostoperative re-interventionPredictive value
万方数据
维普
