超声连续追踪对凶险型前置胎盘伴胎盘植入的早期诊断价值  

Early diagnostic value of ultrasound continuous tracing of pernicious placenta previa and placenta accreta

作　　者：雷晓真 郑九生[1] 黄淑晖[1] 余诧 付群[1] 余诧[1] 夏劲[1] 刘淮 

机构地区：[1]江西省妇幼保健院产科,南昌330006

出　　处：《江西医药》2017年第12期1275-1278,共4页Jiangxi Medical Journal

基　　金：江西省科技厅项目,编号20151BBG70099

摘　　要：目的探讨超声连续检查对凶险型前置胎盘及胎盘植入的早期诊断价值。方法选择2015年6月-2016年8月我院门诊产检具有高危因素的430例孕妇,利用超声检查,从孕早中晚期(4个不同孕周)连续追踪,测量孕囊离宫颈内口的距离,胎盘位置与宫颈内口的距离,子宫下段的厚度,血运,动态观察胎盘迁移情况;比较孕早期(孕2月)孕囊位置在宫腔下1/2与在宫腔上1/2,其妊娠结局发生凶险型前置胎盘的病例数;比较孕14-20周胎盘距宫颈内口<30mm与胎盘距宫颈内口≥30mm,其妊娠结局发生凶险型前置胎盘的病例数;比较孕22-26周B超检查胎盘距宫颈内口<50mm与胎盘距宫颈内口≥50mm,其妊娠结局发生凶险型前置胎盘的病例数;比较孕22-26周B超检查胎盘距宫颈内口<50mm中前壁胎盘与后壁胎盘,其妊娠结局发生凶险型前置胎盘伴胎盘植入的病例数;比较孕30-32周B超提示中央型前置胎盘与部分型前置胎盘、边缘型前置胎盘,其妊娠结局为凶险型前置胎盘伴胎盘植入的病例数;B超提示中央型前置胎盘且为前壁胎盘与部分型前置胎盘、边缘型前置胎盘,其妊娠结局为凶险型前置胎盘伴胎盘植入的病例数。结果⑴孕早期(孕2月)孕囊位置在宫腔下1/2与在宫腔上1/2的比较,结局为凶险型前置胎盘组与非凶险型前置胎盘组不同囊位置的比较,差异有统计学意义(P=0.003);⑵孕14-20周胎盘距宫颈内口<30mm与胎盘距宫颈内口≥30mm的比较,凶险型前置胎盘组与非凶险型前置胎盘组不同胎盘距宫颈内口的比较,差异有统计学意义(P=0.000);⑶孕22-26周胎盘距宫颈内口<50mm与胎盘距宫颈内口≥50mm的比较,凶险型前置胎盘组与非凶险型前置胎盘组不同胎盘距宫颈内口的比较,差异有统计学意义(P=0.000);⑷孕30-32周不同胎盘类型的比较,前壁胎盘组与后壁胎盘组不同胎盘类型的比较,差异有统计学意义(P=0.025)。结论连续超声检查能早�Objective Purpose To explore the relationship between early embryo implantation position,late placenta position and pernicious placenta previa and placenta accreta,and the early diagnostic value of continuous ultrasound examination of pernicious placenta previa and placenta accreta. Methods Take 430 pregnant women in Jiangxi Province Maternal and Child Health Hospital with high risk factors as observation objects from June 2015 to August 2016,apply the use of ultrasound,started the tracking in each stage from early to late pregnancy(4 different gestational weeks),measuring the distance from gestational sac to intrauterine mouth,the distance from intrauterine mouth to placenta,the thickness of the lower uterine segment,blood supply,dynamic observation of placental migration;Compare the number of cases of pernicious pregnancy placenta previa occurring to patients with gestational sac on the top half of uterine cavity with the cases with gestational sac on the lower half. Compare the number of cases of pregnancy pernicious placenta previa occurring to 14-20 weeks pregnant women with the distance from placenta to intrauterine mouth over 30 mm and and cases with the distance under 30 mm. Compare the number of cases of dangerous pregnancy placenta previa occurring to 22-26 weeks pregnant women with the distance from placenta to intrauterine mouth over 50 mm and and cases with the distance under 50 mm. Compare the number of cases of pregnancy pernicious placenta previa occurring to 22-26 weeks pregnant women with gestational sac on the top half of uterine cavity and gestational sac on the lower half with the distance from placenta to intrauterine mouth both under 50 mm. Compare the number of cases of pregnancy pernicious placenta previa occurring to 30-32 weeks pregnant women with ultrasound outcome suggests central placenta previa,partial placenta previa,margin placenta previa. Compare the number of cases of pregnancy pernicious placenta previa occurring to pregnant women with ultrasound outcome suggests central placen

关 键 词：连续超声检查 凶险型前置胎盘 胎盘植入 早期诊断 

分 类 号：R714.2[医药卫生—妇产科学]