罗布森类和剖宫产疤痕缺陷

C. Alovisi, R. Amadori, C. Alovisi, D. Surico
{"title":"罗布森类和剖宫产疤痕缺陷","authors":"C. Alovisi, R. Amadori, C. Alovisi, D. Surico","doi":"10.36811/IJRMSH.2019.110001","DOIUrl":null,"url":null,"abstract":"Caesarean scar defect (CSD) may lead to the occurrence of gynecologic symptoms such as abnormal uterine bleeding secondary to intermittent passage of retained menstrual blood within the CSD pelvic pain, and infertility. This prospective cohort study was conducted at the Department of Obstetrics at Maria Vittoria Hospital in Turin (Italy), from January 2013 to December 2013 to analyze the effects of two different suturing techniques (single layer and double layer closure of the hysterotomy) and Robson's class impact on the incidence of CSD. All procedures were performed using a modified Stark technique by the same single senior surgeon. The way of closure of the uterine incision was alternated every three months, in order to have two groups of partecipants: one with a single layer and the other with a double layer closure technique. Single layer was carried out as one continuous locking stitch; double layer was performed with a first closure identical to the single layer and an additional suture with a continuous unlocked stitch used to imbricate the first layer. Both ways of closure of the uterine incision were performed using monofilament synthetic absorbable polydioxanone suture. Twelve months after their caesarean section, the women had an ultrasound examination of the uterine scar performed by a single experienced operator blinded to suture technique and the Robson class. The trial recruited 85 cases. 21 patients (24.8%) belonged to Robson's class 1, 5(6%) to class 2, 1(1.3%) to class 4, 35(41%) to class 5, 13(15.4%) to class 6, 6(7%) to class 7, 4(4.5%) to class 8. During the ultrasound follow up we found 10 CSD (11,8%): 8/10 CSD (80%) were found in Robson's class 5, 1 in class 1 and 1 in class 6 (p 0.008), with no correlation with single- or double-layer suture (p 0.141). To our knowledge, no previous studies evaluated the correlation with Robson classification and CSD.","PeriodicalId":14247,"journal":{"name":"International Journal of Reproductive Medicine and Sexual Health","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2019-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Robson’s class and caesarean scar defects\",\"authors\":\"C. Alovisi, R. Amadori, C. Alovisi, D. Surico\",\"doi\":\"10.36811/IJRMSH.2019.110001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Caesarean scar defect (CSD) may lead to the occurrence of gynecologic symptoms such as abnormal uterine bleeding secondary to intermittent passage of retained menstrual blood within the CSD pelvic pain, and infertility. This prospective cohort study was conducted at the Department of Obstetrics at Maria Vittoria Hospital in Turin (Italy), from January 2013 to December 2013 to analyze the effects of two different suturing techniques (single layer and double layer closure of the hysterotomy) and Robson's class impact on the incidence of CSD. All procedures were performed using a modified Stark technique by the same single senior surgeon. The way of closure of the uterine incision was alternated every three months, in order to have two groups of partecipants: one with a single layer and the other with a double layer closure technique. Single layer was carried out as one continuous locking stitch; double layer was performed with a first closure identical to the single layer and an additional suture with a continuous unlocked stitch used to imbricate the first layer. Both ways of closure of the uterine incision were performed using monofilament synthetic absorbable polydioxanone suture. Twelve months after their caesarean section, the women had an ultrasound examination of the uterine scar performed by a single experienced operator blinded to suture technique and the Robson class. The trial recruited 85 cases. 21 patients (24.8%) belonged to Robson's class 1, 5(6%) to class 2, 1(1.3%) to class 4, 35(41%) to class 5, 13(15.4%) to class 6, 6(7%) to class 7, 4(4.5%) to class 8. During the ultrasound follow up we found 10 CSD (11,8%): 8/10 CSD (80%) were found in Robson's class 5, 1 in class 1 and 1 in class 6 (p 0.008), with no correlation with single- or double-layer suture (p 0.141). To our knowledge, no previous studies evaluated the correlation with Robson classification and CSD.\",\"PeriodicalId\":14247,\"journal\":{\"name\":\"International Journal of Reproductive Medicine and Sexual Health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-03-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Reproductive Medicine and Sexual Health\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.36811/IJRMSH.2019.110001\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Reproductive Medicine and Sexual Health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36811/IJRMSH.2019.110001","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

剖宫产瘢痕缺损(Caesarean scar缺损,CSD)可导致子宫异常出血继发于CSD内经血潴留间歇性通过盆腔疼痛、不孕症等妇科症状。本前瞻性队列研究于2013年1月至2013年12月在意大利都灵Maria Vittoria医院产科进行,分析两种不同缝合技术(单层和双层子宫切开术)对CSD发生率的影响以及Robson分级对CSD发生率的影响。所有手术均由同一位资深外科医生使用改良的Stark技术进行。子宫切口的闭合方式每三个月交替进行一次,以便有两组参与者:一组采用单层闭合技术,另一组采用双层闭合技术。单层作为一个连续的锁针进行;进行双层缝合,第一次缝合与单层缝合相同,并使用连续无锁缝线进行额外缝合,用于覆盖第一层。两路子宫切口均采用单丝合成可吸收聚二恶酮缝合。剖宫产12个月后,由一名经验丰富的操作员对子宫疤痕进行超声检查,该操作员对缝合技术和Robson类别一无所知。该试验招募了85例患者。21例(24.8%)患者属于Robson分类1级,5例(6%)至2级,1例(1.3%)至4级,35例(41%)至5级,13例(15.4%)至6级,6例(7%)至7级,4例(4.5%)至8级。超声随访发现10例CSD(11.8%): 8/10例CSD(80%)为Robson's 5级,1级1例,6级1例(p 0.008),与单层缝合或双层缝合无关(p 0.141)。据我们所知,以前没有研究评估与Robson分类和CSD的相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Robson’s class and caesarean scar defects
Caesarean scar defect (CSD) may lead to the occurrence of gynecologic symptoms such as abnormal uterine bleeding secondary to intermittent passage of retained menstrual blood within the CSD pelvic pain, and infertility. This prospective cohort study was conducted at the Department of Obstetrics at Maria Vittoria Hospital in Turin (Italy), from January 2013 to December 2013 to analyze the effects of two different suturing techniques (single layer and double layer closure of the hysterotomy) and Robson's class impact on the incidence of CSD. All procedures were performed using a modified Stark technique by the same single senior surgeon. The way of closure of the uterine incision was alternated every three months, in order to have two groups of partecipants: one with a single layer and the other with a double layer closure technique. Single layer was carried out as one continuous locking stitch; double layer was performed with a first closure identical to the single layer and an additional suture with a continuous unlocked stitch used to imbricate the first layer. Both ways of closure of the uterine incision were performed using monofilament synthetic absorbable polydioxanone suture. Twelve months after their caesarean section, the women had an ultrasound examination of the uterine scar performed by a single experienced operator blinded to suture technique and the Robson class. The trial recruited 85 cases. 21 patients (24.8%) belonged to Robson's class 1, 5(6%) to class 2, 1(1.3%) to class 4, 35(41%) to class 5, 13(15.4%) to class 6, 6(7%) to class 7, 4(4.5%) to class 8. During the ultrasound follow up we found 10 CSD (11,8%): 8/10 CSD (80%) were found in Robson's class 5, 1 in class 1 and 1 in class 6 (p 0.008), with no correlation with single- or double-layer suture (p 0.141). To our knowledge, no previous studies evaluated the correlation with Robson classification and CSD.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信