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Diagnosing early scar pregnancy in the lower uterine segment after cesarean section by intracavitary ultrasound

BACKGROUND: Early scar pregnancy (CSP) in the lower uterine segment after cesarean section is a type of ectopic pregnancy that can cause major complications if left untreated. Transabdominal ultrasound is a common procedure but is influenced by external factors. Thus, intracavitary ultrasound may ha...

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Autores principales: Cheng, Xiao-Ling, Cao, Xiao-Yan, Wang, Xiao-Qian, Lin, Heng-Li, Fang, Jin-Chuan, Wang, Lin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8771384/
https://www.ncbi.nlm.nih.gov/pubmed/35097080
http://dx.doi.org/10.12998/wjcc.v10.i2.547
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author Cheng, Xiao-Ling
Cao, Xiao-Yan
Wang, Xiao-Qian
Lin, Heng-Li
Fang, Jin-Chuan
Wang, Lin
author_facet Cheng, Xiao-Ling
Cao, Xiao-Yan
Wang, Xiao-Qian
Lin, Heng-Li
Fang, Jin-Chuan
Wang, Lin
author_sort Cheng, Xiao-Ling
collection PubMed
description BACKGROUND: Early scar pregnancy (CSP) in the lower uterine segment after cesarean section is a type of ectopic pregnancy that can cause major complications if left untreated. Transabdominal ultrasound is a common procedure but is influenced by external factors. Thus, intracavitary ultrasound may have better diagnostic efficiency for CSP. AIM: To assess the value of intracavitary ultrasound for diagnosing CSP in the lower uterine segment after cesarean section. METHODS: Patients diagnosed with CSP in our hospital from October 2019 to April 2021 were recruited. Transabdominal and intracavitary ultrasound examinations were performed to compare the diagnostic differences for CSP and its types. RESULTS: Sixty-three patients were diagnosed during the study period. The diagnostic accuracy for CSP was higher in intracavitary ultrasound (96.83%) than in transabdominal ultrasound (84.13%) (P < 0.05). The missed diagnosis and misdiagnosis rates did not differ among the ultrasound types (intra: 0.00% and 3.17%; trans: 4.76% and 11.11%, respectively; P > 0.05). For the diagnostic rates for the CSP types, the rates for gestational sac (100.00% vs 90.48%), heterogeneous mass (93.75% vs 75.00%), and part of the uterine cavity (80.00% vs 60.00%) were higher in intracavitary ultrasound than in transabdominal ultrasound, but the difference was not statistically significant (P > 0.05). For gestational sac CSP patients, intracavitary ultrasound showed that the gestational sac was located in the lower uterine segment scar with abundant peripheral blood flow; the distance between the gestational sac and the serosal layer was 2.42 ± 0.50 cm. Intracavitary ultrasound for heterogeneous mass CSP patients indicated that the mass mainly occurred in the lower anterior uterine wall, protruding into the bladder, and was surrounded by abundant internal and peripheral blood flow; the distance between the mass and serosal layer was 1.79 ± 0.30 cm. For CSP type partly located in the uterine cavity, the gestational sac was partly located in the lower uterine cavity and partly in the scar with abundant internal and peripheral blood flow; the distance between the gestational sac and the serosal layer was 2.29 ± 0.28 cm. CONCLUSION: Intracavitary ultrasound had a higher diagnostic accuracy and application value for diagnosing CSP than transabdominal ultrasound, with reduced risk of missed diagnoses and misdiagnosis, thereby preventing delayed treatment.
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spelling pubmed-87713842022-01-28 Diagnosing early scar pregnancy in the lower uterine segment after cesarean section by intracavitary ultrasound Cheng, Xiao-Ling Cao, Xiao-Yan Wang, Xiao-Qian Lin, Heng-Li Fang, Jin-Chuan Wang, Lin World J Clin Cases Observational Study BACKGROUND: Early scar pregnancy (CSP) in the lower uterine segment after cesarean section is a type of ectopic pregnancy that can cause major complications if left untreated. Transabdominal ultrasound is a common procedure but is influenced by external factors. Thus, intracavitary ultrasound may have better diagnostic efficiency for CSP. AIM: To assess the value of intracavitary ultrasound for diagnosing CSP in the lower uterine segment after cesarean section. METHODS: Patients diagnosed with CSP in our hospital from October 2019 to April 2021 were recruited. Transabdominal and intracavitary ultrasound examinations were performed to compare the diagnostic differences for CSP and its types. RESULTS: Sixty-three patients were diagnosed during the study period. The diagnostic accuracy for CSP was higher in intracavitary ultrasound (96.83%) than in transabdominal ultrasound (84.13%) (P < 0.05). The missed diagnosis and misdiagnosis rates did not differ among the ultrasound types (intra: 0.00% and 3.17%; trans: 4.76% and 11.11%, respectively; P > 0.05). For the diagnostic rates for the CSP types, the rates for gestational sac (100.00% vs 90.48%), heterogeneous mass (93.75% vs 75.00%), and part of the uterine cavity (80.00% vs 60.00%) were higher in intracavitary ultrasound than in transabdominal ultrasound, but the difference was not statistically significant (P > 0.05). For gestational sac CSP patients, intracavitary ultrasound showed that the gestational sac was located in the lower uterine segment scar with abundant peripheral blood flow; the distance between the gestational sac and the serosal layer was 2.42 ± 0.50 cm. Intracavitary ultrasound for heterogeneous mass CSP patients indicated that the mass mainly occurred in the lower anterior uterine wall, protruding into the bladder, and was surrounded by abundant internal and peripheral blood flow; the distance between the mass and serosal layer was 1.79 ± 0.30 cm. For CSP type partly located in the uterine cavity, the gestational sac was partly located in the lower uterine cavity and partly in the scar with abundant internal and peripheral blood flow; the distance between the gestational sac and the serosal layer was 2.29 ± 0.28 cm. CONCLUSION: Intracavitary ultrasound had a higher diagnostic accuracy and application value for diagnosing CSP than transabdominal ultrasound, with reduced risk of missed diagnoses and misdiagnosis, thereby preventing delayed treatment. Baishideng Publishing Group Inc 2022-01-14 2022-01-14 /pmc/articles/PMC8771384/ /pubmed/35097080 http://dx.doi.org/10.12998/wjcc.v10.i2.547 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Observational Study
Cheng, Xiao-Ling
Cao, Xiao-Yan
Wang, Xiao-Qian
Lin, Heng-Li
Fang, Jin-Chuan
Wang, Lin
Diagnosing early scar pregnancy in the lower uterine segment after cesarean section by intracavitary ultrasound
title Diagnosing early scar pregnancy in the lower uterine segment after cesarean section by intracavitary ultrasound
title_full Diagnosing early scar pregnancy in the lower uterine segment after cesarean section by intracavitary ultrasound
title_fullStr Diagnosing early scar pregnancy in the lower uterine segment after cesarean section by intracavitary ultrasound
title_full_unstemmed Diagnosing early scar pregnancy in the lower uterine segment after cesarean section by intracavitary ultrasound
title_short Diagnosing early scar pregnancy in the lower uterine segment after cesarean section by intracavitary ultrasound
title_sort diagnosing early scar pregnancy in the lower uterine segment after cesarean section by intracavitary ultrasound
topic Observational Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8771384/
https://www.ncbi.nlm.nih.gov/pubmed/35097080
http://dx.doi.org/10.12998/wjcc.v10.i2.547
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