血管前置的产前超声诊断价值及漏诊分析  

The Prenatal Ultrasound Diagnostic Value and Missed Diagnosis Analysis of Vasa Previa

作　　者：沈晓燕[1] 袁华[1] 解左平[1] 朱亚芳[1] 陈金红[2] Shen Xiaoyan;Yuan Hua;Xie Zuoping;Zhu Yafang;Chen Jinhong(Department of Ultrasound,Shaoxing Maternal and Child Health Hospital,Shaoxing,Zhejiang 312000,China;Department of Obstetrics,Shaoxing Maternal and Child Health Hospital,Shaoxing,Zhejiang 312000,China)

机构地区：[1]绍兴市妇幼保健院超声科,浙江省绍兴市312000 [2]绍兴市妇幼保健院产科,浙江省绍兴市312000

出　　处：《中国超声医学杂志》2024年第3期313-315,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨产前超声对胎儿血管前置的诊断价值及漏诊原因。方法 回顾性分析33例患者的超声声像图特征,并随访孕妇妊娠结局及术中所见。结果 33例血管前置患者产前超声明确诊断29例,均具有特征性声像图表现。均合并一至数个高危因素,其中低置胎盘10例,前置胎盘16例,帆状胎盘22例,球拍状胎盘6例,分叶胎盘2例,副胎盘1例,辅助生殖2例,多胎妊娠1例,单脐动脉2例。合并两个以上高危因素共22例(67%,22/33),其中胎盘位置异常伴帆状胎盘占15例(68%,15/22)。结论 产前超声诊断血管前置简便、可靠、易推广。当常规产前检查过程中发现有上述高危因素时,需仔细检查宫颈内口前置血管,从而有效避免不良妊娠结局的发生。Objective To explore the diagnostic value of prenatal ultrasound in the diagnosis of fetal vasa previaand the reasons for missed diagnosis.Methods A retrospective analysis of the ultrasound images of 33 patients was conducted,and their pregnancy outcomes and intraoperative findings were followed up.Results Prenatal ultrasound accurately diagnosed 29 cases of vasa previa among the 33 patients,all of which showed characteristic ultrasound features.All patients had one or more high-risk factors,including 10 cases of low-lying placenta,16 cases of anterior placenta,22 cases of sail-shaped placenta,6 cases of racquet-shaped placenta,2 cases of lobed placenta,1 case of accessory placenta,2 cases of assisted reproduction,1 case of multiple pregnancies,and 2 cases of single umbilical artery.A total of 22 cases(67%,22/33) had two or more high-risk factors,with abnormal placental position accompanied by sail-shaped placenta accounting for 15 cases(68%,15/22).Conclusions Prenatal ultrasound diagnosis of vasa previais simple,reliable,and easily applicable.When the above high-risk factors are identified during routine prenatal examinations,careful examination for the presence of vasa previa at the internal cervical ostium is necessary to effectively prevent adverse pregnancy outcomes.

关 键 词：产前 超声 血管前置 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]