Bladder horn appearance on ultrasonographic examination prior to cesarean section: Does it predict high cranial attachment of the bladder?

AMAÇ: Bu çalışmanın amacı, preoperatif ultrasonografik olarak saptanan mesanede boynuzsu görünümün mesanenin yukarı çekilmesini öngörmedeki yerini araştırmaktır. GEREÇ VE YÖNTEM: Çalışma bir eğitim araştırma hastanesinin doğum servisinde yürütülmüş olup, çalışmaya 37 haftayı tamamlamış, en az bir geçirilmiş sezaryen ameliyatı olan, mesanede boynuzsu görünüm saptanan 66 ve saptanmayan 134, toplam 200 gebe dahil edilmiştir. BULGULAR: Boynuzsu görünüm tespit edilen hastaların %33,3’ü ile tespit edilmeyen hastaların %26,9’unda mesanenin yukarı çekildiği görülmüştür (p=0,51). Mesane ve uterus arasında flep oluşturulması esnasında keskin diseksiyona ihtiyaç gösteren dens adezyonların varlığı açısından da her iki grup arasında fark bulunmamıştır (%22,7 vs. %20.2) (p>0,05). SONUÇ: Ultrasonografik olarak saptanan mesane tabanının uterusa boynuz şeklinde yapışma görüntüsü, mesanenin yukarı çekilmesini predikte edememektedir.

Sezaryen öncesi yapılan ultrasonografide mesanede boynuzsu görünümün saptanması mesanenin yukarı çekilmesini öngörebilirmi?

OBJECTIVE: To investigate the value of bladder horn appearance seen on ultrasonography performed prior to cesarean section in prediction of high cranial attachment of bladder. STUDY DESIGN: The study was carried out in delivery unit of a teaching hospital. Two hundred preg- nant women, 66 with and 134 without ultrasonographic appearance of bladder horn with at least one previous CS delivery beyond 37 weeks of gestation were enrolled in the study. RESULTS: The rate of high cranial attachment of the bladder in patients with or without bladder horn appearance is 33.3% and 26.9%, respectively (p=0.51). There was no difference in the incidence of dense adhesions between uterus and bladder requiring sharp dissection to create a bladder flap be- tween two groups (22.7% vs. 20.2%) (p>0.05). CONCLUSION: Ultrasonographic appearance of horn shaped attachment of bladder base to the uterus does not predict the high attachment of bladder to the uterus.

Kaynakça

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