前置血管17例临床分析  

Clinical Analysis of 17 Cases of Vasa Previa

作　　者：吕菁菁 孔琰 王宁[1] 

机构地区：[1]青岛大学附属医院,山东 青岛

出　　处：《临床医学进展》2022年第10期8914-8918,共5页Advances in Clinical Medicine

摘　　要：目的:探讨前置血管的临床特点及围生儿结局。方法:回顾性分析2018年1月至2020年12月青岛大学附属医院收治前置血管17例临床资料,分析其临床特征、终止时机和围产儿结局。结果:① 临床特征:17例前置血管患者平均年龄33岁,平均体质量指数(BMI) 26.82 Kg/m2;单胎16例(94.1%),双胎1例(5.9%);孕期超声诊断前置血管并经分娩时确诊15例(88.2%),孕期超声未提示,但分娩时诊断2例(11.7%)。② 分娩方式及围生儿结局:6例(35.2%)于孕晚期入院管理,孕37周经剖宫产娩出;8例(47.1%)孕期超声诊断前置血管,因先兆早产行紧急剖宫产,其妊娠结局良好,新生儿出生后1分钟Apgar评分均为9~10分;1例(5.9%)于孕22周超声检查出来,因染色体异常行中孕引产术;1例(5.9%)孕期超声未诊断前置血管,孕34周因胎膜早破行催产素引产,引产过程阴道流血中转剖宫产,术中诊断前置血管,新生儿Apgar评分(1~5 min) 5~7分;1例(5.9%)于孕40周因社会因素行剖宫产,术中发现前置血管,新生儿评分10分。17例患者中,帆状胎盘8例(47.1%),副胎盘2例(11.7%),前置胎盘并胎盘植入5例(29.5%),2例(11.7%)胎盘未见明显异常。结论:产前超声是前置血管诊断的可靠方法,孕晚期适时剖宫产终止妊娠有助于良好的围生儿结局。Objective: To study the clinical features of vasa previa and outcome of perinatal infant. Methods: 17cases of vasa previa who admitted in The Affiliated Hospital of Qingdao University from January 2018 to December 2020 were recruited. The clinical data, the management and perinatal outcome were analyzed retrospectively. Results: 1) Clinical features: The mean age of 17 patients with vasa previa was 33 years, and the mean body mass index (BMI) was 26.82 Kg/m2. There were 16 single fetuses (94.1%) and 1 twin fetuses (5.9%). 15 cases (88.2%) were diagnosed by ultrasound during pregnancy and confirmed by delivery, but 2 cases (11.7%) were diagnosed by ultrasound during delivery. 2) Delivery mode and perinatal outcome: 6 cases (35.2%) were hospitalized in late preg-nancy and delivered by cesarean section at 37 weeks of gestation;Eight cases (47.1%) were diag-nosed as vasa previa by ultrasound during pregnancy and underwent emergency cesarean section due to preterm labor with aura. The pregnancy outcome was good and Apgar score was 9~10 in 1 minute after birth. One patient (5.9%) was diagnosed by ultrasound at 22 weeks of gestation and underwent midpregnancy induced labor due to chromosomal abnormalities. One case (5.9%) was not diagnosed with prefrontal vessels by ultrasound during pregnancy. At 34 weeks of gestation, labor was induced by oxytocin due to premature rupture of membranes, vaginal bleeding during labor induction was transferred to cesarean section. Prefrontal vessels were diagnosed during op-eration, and Apgar score (1~5 min) was 5~7. One case (5.9%) underwent cesarean section at 40 weeks of gestation due to social factors. Prefrontal vessels were found during the operation. Neona-tal score was 10. Among the 17 patients, there were 8 cases (47.1%) of Vela placenta, 2 cases (11.7%) of accessory placenta, 5 cases (29.5%) of placenta previa with placenta implantation, and 2 cases (11.7%) of placenta without obvious abnormality. Conclusion: Prenatal ultrasound is a relia-ble method for vasa previa diagnosis,

关 键 词：前置血管 临床特点 围产儿结局 

分 类 号：R714.4[医药卫生—妇产科学]