胎盘早剥宫腔积血范围联合脐动脉血流测量快速预测妊娠结局的价值  

The value of placental abruption hematocele range combined with umbilical artery flow measurement in rapid prediction of pregnancy outcomes

作　　者：李清[1] 张利敏[1] 郑学东[1] LI Qing;ZHANG Limin;ZHENG Xuedong(Department of Ultrasound,Maternity and Child Health Care of Zaozhuang,Zaozhuang,Shandong,277100,China)

机构地区：[1]枣庄市妇幼保健院超声科,山东枣庄277100

出　　处：《当代医学》2025年第1期116-119,共4页Contemporary Medicine

摘　　要：目的探讨胎盘早剥宫腔内积血范围联合脐动脉血流测量快速预测妊娠结局的价值。方法回顾性分析2018年1月至2022年12月于枣庄市妇幼保健院经手术证实为胎盘早剥的93例孕妇的临床资料,识别宫腔内胎盘周围积血并测量其最大长度、厚度,测量脐动脉血流收缩期末/舒张期末的最大血流速度比值(systolic velocity/end diastolicvelocity,S/D)、胎心率,随访分娩后产妇及新生儿预后。将胎盘早剥孕妇分为中孕期及晚孕期,不同孕期孕妇根据新生儿Apgar评分分为无窒息组、有窒息组及死胎组,比较各组间宫腔积血范围(积血长度、积血厚度)。根据脐动脉血流情况将所有患者分为胎心正常、胎心异常及胎心消失,统计不同胎心情况对应的母婴结局情况。结果中孕期重度窒息新生儿4例,死胎13例,中孕期胎盘早剥新生儿预后差,新生儿死亡率达76.47%(13/17)。孕晚期产妇中无窒息49例,有窒息20例,死胎7例。胎心异常12例,胎心消失10例,胎心正常71例。晚孕期无窒息组宫腔积血长度短于死胎组、有窒息组,无窒息组与有窒息组宫腔积血厚度薄于死胎组,且无窒息组薄于有窒息组,差异有统计学意义(P<0.05);有窒息组与死胎组宫腔积血长度比较差异无统计学意义。中孕期8例产妇发生并发症,晚孕期51例产妇发生并发症。胎心异常12例产妇均有产后出血,胎心消失10例均证实为死胎。结论随着宫腔内积血范围增加,新生儿窒息、死胎及产妇并发症明显增加,伴随脐动脉血流出现异常时,新生儿及孕妇并发症明显增加。Objective To explore the value of placental abruption hematocele range combined with umbilical artery flow measurement in rapid prediction of pregnancy outcomes.Methods A retrospective analysis was conducted on the clinical data of 93 pregnant women with placental abruption confirmed by surgery at Maternity and Child Health Care of Zaozhuang from January 2018 to December 2022.The hematoma around the placenta in the uterine cavity was identified,and its maximum length and thickness were measured.The systolic velocity/end diastolic velocity(S/D)ratio of umbilical artery blood flow and fetal heart rate were also measured,the outcomes of mothers and newborns after delivery were followed up.The pregnant women with placental abruption were divided into the second-trimester and the third-trimester.Based on the neonatal Apgar score,each trimester was further divided into the no-asphyxia group,the asphyxia group and the stillbirth group,and the range of uterine hematoma(hematoma length and thickness)among different groups was compared.All patients were classified into normal fetal heart rate,abnormal fetal heart rate and absent fetal heart rate according to umbilical artery blood flow conditions,the maternal and infant outcomes corresponding to different fetal heart rate conditions were analyzed.Results In the second trimester,there were 4 cases of severe neonatal asphyxia and 13 cases of stillbirth,the prognosis of newborns in the second trimester was poor,with a neonatal mortality rate of 76.47%(13/17).In the third-trimester pregnant women,there were 49 cases with no asphyxia,20 cases with asphyxia,and 7 cases of stillbirth.There were 12 cases of abnormal fetal heart rate and 10 cases of absent fetal heart rate,while 71 cases had normal fetal heart rates.In the third-trimester,the length of uterine hematoma in the no-asphyxia group was shorter than that in the stillbirth group and the asphyxia group,the thickness of uterine hematoma in the no-asphyxia group and the asphyxia group was thinner than that in the stillbirth

关 键 词：超声检查 胎盘早剥 妊娠结局 母婴预后 

分 类 号：R714.2[医药卫生—妇产科学]