超声检查对血管前置的产前诊断评价  

Evaluation of Ultrasonography in the Antenatal Diagnosis of Vasa Previa

作　　者：杨贵岚 廖林 朱青霞 胡会敏 施君 黄双凤 邵丽 Yang Guilan;Liao Lin;Zhu Qingxia;Hu Huimin;Shi Jun;Huang Shuangfeng;Shao Li(Department of Ultrasound,The Seventh People’s Hospital of Chengdu,Chengdu 610213,China;Department of Ultrasound,Chengdu West Angel Women’s and Children’s Hospital,Chengdu 610036,China)

机构地区：[1]成都市第七人民医院超声医学科,成都市610213 [2]成都西区安琪儿妇产医院超声科,成都市610036

出　　处：《中国超声医学杂志》2024年第4期456-458,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨产前超声筛查血管前置(VP)的关键、最佳的筛查方案以及途径选择,以期提高VP的产前检出率。方法将61例剖宫产孕妇的病历资料纳入研究,产前均曾因临床疑诊VP而序贯给予经腹部超声(TAS)和经阴道超声(TVS)检查。将中孕期超声筛查加定期随诊筛查VP的设为A类筛查方案,将仅行晚孕期超声筛查方案设为B类筛查方案,统计分析不同筛查方案及途径选择对VP的产前诊断效能。结果经手术后-胎盘检查确证,45例孕妇伴发VP,16例无VP。A方案诊断VP的准确度(100%)明显高于B方案(75.0%)(P<0.05);相较于TAS,TVS应用于诊断VP,在灵敏度、特异度及准确度等方面均具明显优势(P<0.05)。结论宫颈内口附近探及胎膜下血管是超声诊断VP的关键,中孕期超声筛查加定期随诊为筛查的最佳方案,TVS为筛查的最佳途径。Objective The study was aimed to improve the prenatal detection rate of vasa previa(VP)by ultrasonography.The key points,optimal screening plan,and pathway selection of prenatal ultrasound screening for VP was investigated.Methods The medical records of 61 pregnant women who were given cesarean section were evaluated in the study,all of whom underwent transabdominal ultrasonography(TAS)and transvaginal ultrasonography(TVS)due to clinically suspected VP.Class A screening scheme was defined asthe scheme of mid pregnancy ultrasound screening plus regular follow-up screening VP,and Class B screening scheme was defined as the scheme of late pregnancy only.The prenatal testing efficacy of different screening schemes and approaches for VP was assessed.Results According to the postpartum placental examination,45 pregnant women developed VP,and 16 not.The accuracy of diagnosing VP in Plan A(100%)was significantly higher than that in Plan B(80.0%)(P<0.05);Compared to TAS,TVS had significant advantages in sensitivity,specificity,and accuracy in the diagnosis of VP(P<0.05).Conclusions For VP,the key point for diagnosis is to detect the fetal membrane blood vessels near the internal orifice of the cervix.The mid pregnancy ultrasound screening plus regular follow-up is the best screening scheme,however,TVS is the best screening way.

关 键 词：经腹部 经阴道 检查时机 超声检查 血管前置 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]