子宫动脉超声UtA-PI、UtA-RI指数检测对凶险性前置胎盘植入深度及产后出血的预测价值  

Predictive value of uterine artery ultrasound UtA-PI and UtA-RI index detection in predicting depth of dangerous placenta accreta and postpartum hemorrhage

作　　者：许玉静[1] 霍晓恺[1] 鲍金双 赵胜利[1] XU Yujing;HUO Xiaokai;BAO Jinshuang;ZHAO Shengli(Department of Ultrasound,Liaocheng Second People's Hospital,Liaocheng Shandong 252600,China)

机构地区：[1]聊城市第二人民医院超声科,山东聊城252600

出　　处：《新疆医科大学学报》2022年第8期852-857,共6页Journal of Xinjiang Medical University

基　　金：山东省医药卫生科技发展计划项目(2019WS104)。

摘　　要：目的 探讨子宫动脉超声子宫动脉搏动指数(UtA-PI)、子宫动脉阻力指数(UtA-RI)检测对凶险性前置胎盘植入深度及产后出血的预测价值。方法 选取2018年4月至2021年4月聊城市第二人民医院超声科收治的凶险性前置胎盘植入患者74例作为观察组,选取同期同孕周胎盘位置正常孕妇48例为对照组。比较两组基线资料及UtA-PI、UtA-RI,分析UtA-PI、UtA-RI与胎盘植入深度的相关性,Logistic回归分析凶险性前置胎盘植入患者产后出血的影响因素,受试者工作特征曲线(ROC)分析UtA-PI、UtA-RI对产后出血的预测价值。结果 观察组流产史比例高于对照组,UtA-PI、UtARI低于对照组(P<0.05);不同类型胎盘植入患者UtA-PI、UtA-RI具有明显差异(P<0.05),随胎盘植入深度增加,UtA-PI、UtA-RI逐渐降低(P<0.05);凶险性前置胎盘植入患者UtA-PI、UtA-RI与胎盘植入深度呈负相关(P<0.05);Logistic回归模型分析显示,胎盘植入深度增加及UtA-PI、UtA-RI降低均为凶险性前置胎盘植入患者产后出血的独立危险因素(P<0.05);ROC显示,UtA-PI、UtARI联合预测凶险性前置胎盘植入患者发生产后出血的曲线下面积(AUC)为0.918,高于单独预测。结论 子宫动脉超声UtA-PI、UtA-RI与凶险性前置胎盘植入深度呈负相关,且可有效预测产后出血发生风险,应做好多科协作及应急防范处置。Objective To investigate the predictive value of uterine artery ultrasound uterine artery pulsatility index(UtA-PI) and uterine artery resistance index(UtA-RI) in the depth of dangerous placenta accreta and postpartum hemorrhage.Methods From April 2018 to April 2021,74 patients with dangerous placenta previa in the hospital were selected as observation group,and 48 pregnant women with normal placenta in the same gestational week were selected as control group.The baseline data,UtA-PI and UtA-RI were compared between the two groups.The correlation between UtA-PI,UtA-RI and the depth of placental implantation were analyzed.Logistic regression model was used to analyze the influencing factors of postpartum hemorrhage in patients with dangerous placenta previa.The receiver operating characteristic curve(ROC) was used to analyze the predictive value of UtA-PI and UtA-RI for postpartum hemorrhage.Results The abortion history in observation group was higher than that in control group,and UtA-PI and UtARI were lower than those in control group(P < 0.05).There were significant differences in UtA-PI and UtA-RI in patients with different types of placenta accreta(P < 0.05).As the depth of placenta accreta was increased,UtA-PI and UtA-RI gradually were decreased(P < 0.05).UtA-PI and UtA-RI in patients with dangerous placenta previa were negatively correlated with the depth of placenta accreta(P < 0.05).Logistic regression analysis showed that the increasing in the depth of placenta accreta and the decreasing in UtA-PI and UtA-RI were independent risk factors for postpartum hemorrhage in patients with dangerous placenta previa(P < 0.05).ROC showed that the combination of UtAPI and UtA-RI predicted AUC of postpartum hemorrhage in patients with dangerous placenta previa was 0.918,and it was higher than the single prediction.Conclusion Uterine artery ultrasound UtA-PI and UtA-RI are negatively correlated with the depth of dangerous placenta previa implantation and can effectively predict the risk of postpartum hemorrhage.It is a

关 键 词：子宫动脉搏动指数 子宫动脉阻力指数 凶险性前置胎盘植入 植入深度 产后出血 

分 类 号：R714[医药卫生—妇产科学]