胎盘植入性疾病的产前超声图像特征及妊娠结局分析  

Prenatal Ultrasound Imaging Features and Analysis of Pregnancy Outcomes in Patients with Placental Implantation Disorders

作　　者：魏芸[1] 陈洁[1] 赵青[1] 付静静 邢媛媛[1] 王立娟[1] Wei Yun;Chen Jie;Zhao Qing;Fu Jingjing;Xing Yuanyuan;Wang Lijuan(Department of Comprehensive Ultrasound,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院综合超声科,北京市100029

出　　处：《中国超声医学杂志》2024年第5期562-565,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨各类型胎盘植入产前超声图像特征,以提高诊断准确度。方法纳入69例怀疑胎盘植入患者的超声和临床资料,总结各类型胎盘植入超声图像特征,并分析妊娠结局。结果非重型胎盘植入46例,重型23例(17例植入型和6例穿透型)。重型组与非重型组比较:胎盘后低回声带消失或中断、胎盘陷窝、胎盘基底部血流信号增多成团、膀胱线中断或消失、胎盘陷窝融合成片、胎盘基底部跨界血管6种超声征象发生率差异均有统计学意义(P<0.05),植入型与穿透型组胎盘陷窝融合成片与胎盘基底部跨界血管发生率差异均有统计学意义(P<0.05)。上述有统计学意义的6种超声征象,91.30%的重型组同时存在2种或2种以上,78.26%的非重型组仅存在0或1种。重型组术中出血量、子宫全部或部分切除率及胎儿早产率均明显高于非重型组(P<0.05)。结论利用产前超声图像特征能较好地诊断出重型胎盘植入,并能初步诊断重型胎盘植入类型,为临床决策提供重要参考信息。Objective To explore the characteristics of prenatal ultrasound imaging of various types of placental implantation diseases to improve the accuracy of prenatal diagnosis.Methods The ultrasonic and clinical data of 69 patients with suspected placental implantation were recruited,the ultrasound image distribution characteristics of various types of placental implantation were summarized,and the pregnancy outcome was analyzed.Results There were 46 cases of non-severe placental implantation,23 cases of severe type(17 cases with implantation and 6 with penetration).There were statistically significant differences in the incidence of 6 kinds of ultrasound signs in the severe group compared with the non-severe group,including the disappearance or interruption of retroplacental hypoechoic cords,placental lacunae,increased blood flow signals in the placental base,interruption or disappearance of the bladder line,fusion of the placental lacunae and transboundary vessels in the placental base(P<0.05).There were significant differences in the incidence of placental lacunae fusion and transboundary vessels in the basal part of placenta between the implantation and penetration groups(P<0.05).Among the above-mentioned 6 kinds of ultrasound signs with statistical difference,91.30%of severe group had two or more kinds,and 78.26%of non-severe group had only zero or one kind.The intraoperative blood loss,total or partial hysterectomy rate and premature birth rate in severe group were significantly higher than those in non-severe group(P<0.05).Conclusions The use of prenatal ultrasound features can help to better diagnose severe placenta implatation,and the type of severe placental implantation can be initially diagnosed,providing important reference information for clinical decision-making.

关 键 词：胎盘植入 超声 妊娠结局 

分 类 号：R71[医药卫生—妇产科学]