产前超声在凶险型胎盘前置伴胎盘植入患者中的诊断价值  

Diagnostic Value of Prenatal Ultrasound in Patients with Dangerous Placenta Previa Accompanied by Placenta Implantation

作　　者：徐洁[1] 吴桂花[1] 蔡海云[1] 刘亚军[1] Xu Jie;Wu Guihua;Cai Haiyun;Liu Yajun(Department of Ultrasound,W uzhong Peoples Hospital,Suzhou City,Suzhou,Jiangsu 215128)

机构地区：[1]苏州市吴中人民医院超声科,江苏苏州215128

出　　处：《现代医用影像学》2020年第12期2223-2226,共4页Modern Medical Imageology

摘　　要：目的:探讨孕晚期凶险型胎盘前置伴胎盘植入患者的产前超声特征,以提高对胎盘前置伴胎盘植入的认识及产前超声检出率。方法:收集2017年3月—2019年12月就诊我院,经超声孕检提示胎盘前置伴或不伴胎盘植入患者50例,其中包括凶险型前置胎盘组患者12例和非凶险型前置胎盘组患者38例,分析各超声征象在两组中的特征性,对照产前超声诊断与手术及病理诊断结果,分析产前超声诊断凶险型前置胎盘伴胎盘植入的敏感性、特异性、误诊率及漏诊率。结果:50例患者产前超声检查均提示胎盘前置,产后临床诊断结果是48例患者存在胎盘前置,诊断符合率为99%。其中,完全型前置胎盘30例,部分型前置胎盘5例,边缘型前置胎盘15例。50例患者产前超声诊断13例伴发胎盘植入,其中12例凶险型伴胎盘植入10例,38例非凶险型伴胎盘植入3例。对照术后结果:在12例凶险型前置胎盘患者中,诊断11例伴发胎盘植入,占91%,高于非凶险型患者伴发胎盘植入发生率(8%);两组胎盘植入发生率比较有统计学差异(P<0.05)。在两组中产前超声诊断胎盘植入的灵敏度、特异度、漏诊率、误诊率分别为:凶险型前置胎盘组85%、70%、7%、15%;非凶险型前置胎盘组72%、88%、18%、4%。产前超声检查对凶险型胎盘前置伴胎盘植入的误诊率远高于非凶险型前置胎盘患者。结论:产前超声检查对胎盘前置及胎盘植入具有较好的诊断效能,为临床治疗方案选择提供可靠的参考依据,有望作为孕晚期患者的常规孕检项目,值得在临床中广泛推广应用。Objective:To explore the prenatal ultrasound features of dangerous placenta previa with placenta accreta in the third trimester of pregnancy, so as to improve the understanding of placenta previa with placenta accreta and the prenatal ultrasound detection rate.Methods:50 cases of placenta previa with or without placenta accreta were collected from March 2017 to December 2019, including 12 cases of dangerous placenta previa and 38 cases of non-dangerous placenta previa. The characteristics of each ultrasound sign in the two groups were analyzed. The sensitivity, specificity, misdiagnosis rate and missed diagnosis rate of prenatal ultrasound diagnosis of dangerous placenta previa with placenta accreta were analyzed by comparing the results of prenatal ultrasound diagnosis with surgical and pathological diagnosis.Results:Prenatal ultrasound examination showed placenta previa in 50 patients, and postpartum clinical diagnosis showed that 48 patients had placenta previa, and the diagnostic coincidence rate was 99%. Among them, there were 30 cases of complete placenta previa, 5 cases of partial placenta previa and 15 cases of marginal placenta previa. Among 50 patients, prenatal ultrasound diagnosed 13 cases with placenta accreta, including 12 dangerous cases with placenta accreta in 10 cases, 38 non-dangerous cases with placenta accreta in 3 cases.Control postoperative results: Among 12 patients with dangerous placenta previa, 11 cases were diagnosed with placenta accreta, accounting for 91%, which was higher than that of non-dangerous patients with placenta accreta(8%);The incidence of placenta accreta between the two groups was statistically different(P<0.05). The sensitivity, specificity, missed diagnosis rate and misdiagnosis rate of prenatal ultrasound in the two groups were 85%, 70%, 7% and 15%, respectively. In the non-dangerous placenta previa group, 72%, 88%, 18% and 4%. The misdiagnosis rate of dangerous placenta previa with placenta accreta by prenatal ultrasound examination is much higher than that of non-d

关 键 词：胎盘前置 胎盘植入 孕检 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.462[医药卫生—诊断学]