基于最新Delphi共识对剖宫产瘢痕妊娠的超声诊断及妊娠结局分析  

Ultrasound diagnosis and pregnancy outcome analysis of cesarean scar pregnancy based on the latest Delphi consensus

作　　者：周春慧 喻红霞[1] 孙雪[1] 王燕华[1] ZHOU Chunhui;YU Hongxia;SUN Xue;WANG Yanhua(Department of Ultrasound,Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第二附属医院超声科,河南郑州450000

出　　处：《中国中西医结合影像学杂志》2024年第6期705-709,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:基于最新Delphi共识分析剖宫产瘢痕妊娠(CSP)的超声诊断及妊娠结局。方法:回顾性分析孕早期超声检查诊断为CSP的孕妇207例,孕周5~8周,平均(6.6±0.4)周。根据最新Delphi共识对CSP的定义及分型标准(CSPA、B、C型)重新诊断,并比较与初始诊断结果的差异。结果:207例中继续妊娠至生产共50例(24.2%);根据最新Delphi共识重新诊断,50例中CSP18例(36.0%),其中CSPA型12例(24.0%),B型6例(12.0%),C型0例;低位置妊娠32例(64.0%)。50例均经剖宫产分娩,23例发生胎盘植入性疾病(PASD);23例PASD中,CSPA型、B型及低位置妊娠3组孕周、出血量、平均住院时间差异均有统计学意义(均P<0.05)。207例中,157例(75.8%)选择终止妊娠,且重新诊断均为CSP,其中A型39例(24.8%)、B型103例(65.6%)、C型15例(9.6%);A、B、C型诊断时剖宫产次数、平均住院时间、宫腔妊娠物残留情况差异均有统计学意义(均P<0.05)。结论:最新Delphi共识中的CSP诊断及分型标准对临床决策具有一定参考价值。Objective:To explore the ultrasound diagnosis and pregnancy outcome analysis of cesarean scar pregnancy(CSP)based on the latest Delphi consensus definition.Methods:A retrospective analysis included 207 women with 5~8(6.6±0.4)weeks of pregnancy,which were diagnosed by ultrasonogrphy in early pregnancy.According to the lastest Delphi consensus definition and classification criteria(CSP A,B,C types),207 cases were rediagnosed,and the variability of the diagnostic results to initial diagnosis was compared.Results:A total of 50 cases(24.2%)in 207 cases were continued the pregnancy until the birth.18 cases(36.0%)were rediagonsed with CSP,including 12 cases(24.0%)of CSP A type,6 cases(12.0%)of CSP B type,zero of CSP C type,and 32 cases(64.0%)were rediagonsed with low position pregnancy.50 women were delivered by cesarean section,and placenta accreta spectrum disorders(PASD)occurred in 23 cases,and of the 23 patients with PASD,there were significantly statistical differences of gestational age,amount of bleeding and average stay among CSP A type,CSP B type and low-implanted pregnancy(all P<0.05).A total of 157 cases(75.8%)of the 207 patients selected to terminate pregnancy and rediagnosed with CSP according to the latest Delphi consensus,among them,39 cases(24.8%)were in CSP A type,103 cases(65.5%)in CSP B type,15 cases(9.6%)in CSP C type.There were significantly statistical differences in number of cesarean sections,average stay and residual intrauterine pregnancy in CSP A,B and C types(all P<0.05).Conclusion:CSP diagnosis and classification standard in the latest Delphi consensus have certain reference values for clinical decision-making.

关 键 词：剖宫产瘢痕妊娠 剖宫产切口 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.22[医药卫生—诊断学]