ObjectiveTo analyze the diagnostic accuracy on patients with Cesarean scar pregnancy underwent transvaginal ultrasound and its influencing factors. MethodsA total of 200 patients suspected Cesarean scar pregnancy were enrolled and analyzed. All patients underwent transvaginal ultrasound and hysteroscopic operation, and the final operative and pathological findings were taken as the gold standard, to estimate the sensitivity, specificity and accuracy of diagnosis via transvaginal ultrasound. Kappa test was conducted on the results of diagnosis, to evaluate the consistency according to the value of Kappa. Patients were assigned to ultrasonic diagnosis without error group and ultrasonic diagnosis with error group according to the operative and pathological findings, and the univariate and multivariate logistic regression model were employed to analyze the influencing factors for the diagnostic accuracy on Cesarean scar pregnancy via transvaginal ultrasound. Results(1) A hundred and sixty nine of 200 patients suspected Cesarean scar pregnancy had ultrasonic image without gestation sac in uterine cavity, whereas with gestation sac or chaotic echo structure in uterine incision scar, among which 78 cases had gestation sac in uterine incision scar, 56 cases revealed chaotic echo area in uterine incision scar, and the remaining 35 cases had hyperechoic villi around gestation sac attached to uterine incision scar. (2) The diagnostic sensitivity, specificity and accuracy via transvaginal ultrasound were 91.21%, 83.33%, and 90.50%, and the consistency between examinations of transvaginal ultrasound and hysteroscopy was intermediate (Kappa=0.562). (3) Univariate analysis revealed that there were statistically significant differences in pelvic effusion, mixed mass, distance between gestation sac and uterine incision scar between the ultrasonic diagnosis without error group and the ultrasonic diagnosis with error group (all P＜0.05), whereas with no statistically significant differences in age, times of Cesarean section, history of uterine fibroids between the two groups (all P＞0.05). Multivariate logistic regression analysis interpreted that pelvic effusion, mixed mass, distance between gestation sac and uterine incision scar were the independent risk factors influencing the diagnostic accuracy via transvaginal ultrasound. ConclusionA favorable examination and estimation to patients with Cesarean scar pregnancy can be revealed via transvaginal ultrasound, which has high diagnostic accuracy; however, there are various factors influencing the diagnostic accuracy. Doctors should properly intervene or dispose those factors, including pelvic effusion, mixed mass, distance between gestation sac and uterine incision scar.

无