| Objective To establish a logistic regression model of ultrasound parameters combination, and analyzed its value in predicting the risk of major bleeding in cesarean scar pregnancy. Methods A total of 120 patients with cesarean section scar pregnancy who received treatment in Baoding First Central Hospital from December 2019 to December 2021 were gathered as the research objects. Patients with significant intraoperative bleeding were recorded as the observation group (35 cases), and those with minimal bleeding as the control group (85 cases). The level of human chorionic gonadotropin (HCG) in the patients was detected, and the ultrasound indexes and HCG levels were compared between the two groups. Multivariate analysis was performed to analyze the factors affecting the occurrence of cesarean scar pregnancy bleeding, and draw ROC curve was drawn to evaluate the predictive value of logistic model combined with ultrasound parameters. Results There were significant differences in blood flow grading and lesion type between the two groups (P<0.05); the lesions in the observation group were significantly larger [(31.58±3.89) cm vs (28.46±3.12) cm] (P<0.05), and the thickness of the residual muscle layer was significantly thinner [(0.98±0.23) cm vs (1.52±0.45) cm] (P<0.05). The results of multivariate regression analysis showed that larger lesions, thinner residual myometrium and blood flow of grade 3 were independent risk factors for massive bleeding in cesarean section scar pregnancy (P<0.05); incorporating the above factors into the Logistic regression model could obtain the probability of massive bleeding in patients with cesarean section scar pregnancy, and then draw the ROC curve was drawn according to the probability value, and the results showed that, ROC curve was 0.945 (95%CI: 0.888~0.978), and the sensitivity was 94.29%, 88.24%,respectively. Conclusions A logistic regression model constructed based on ultrasound parameters such as lesion size, residual muscle layer thickness, and blood flow grading can effectively predict the risk of intraoperative massive bleeding in patients with cesarean scar pregnancy. |
