帆状胎盘69例的超声诊断结果分析

Ultrasonic Diagnosis of Velamentous Cord Insertion:Report of 69 Cases

目的探讨帆状胎盘的超声诊断特点,为临床超声诊断提供参考。方法对我院2007—2010年69例帆状胎盘的超声诊断情况进行回顾性分析。结果 69例帆状胎盘中,脐带帆状附着42例(占60.9%),前置血管12例(占17.4%),副胎盘型7例(占10.1%),双叶胎盘型4例(占5.8%),双胎型4例(占5.8%)。超声诊断帆状胎盘62例,与病理诊断的符合率为88.4%(61/69);误诊为球拍状胎盘5例,误诊率为7.3%(5/69);漏诊3例,漏诊率为4.3%(3/69)。孕<28周的超声与病理诊断符合率为95.6%,孕≥28周的超声与病理诊断符合率为75.0%,两者比较差异有统计学意义(2χ=4.603,P=0.032)。结论彩色多普勒超声是诊断帆状胎盘的重要手段,孕<28周时帆状胎盘的超声与病理诊断符合率高,对于降低围生儿死亡率、指导临床诊治有重要的意义。

Objective To investigate the ultrasonic characteristics of velamentous cord insertion so as to provide refer- ence for clinical diagnosis. Methods A total of 69 velamentous cord insertion cases from our hospital between 2007 and 2010 were retrospectively analyzed. Results Of the 69 cases of velamentous cord insertion, 42 （60. 9% ） were with cord velamentous insertion, 12 （ 17.4% ） were with vasa praevia, 7 （ 10. 1% ） were with accessory placenta, 4 （5.8%） were with bilobed placenta, 4 （5.8%） were with bigeminal placenta. Velamentous cord insertion were diagnosed in 62 cases, with a diagnosis rate of 88.4% （61/69） . Misdiagnosis （as racket -shaped placenta） was made in 4 cases with a misdiagnosis rate of 7. 3% （5/69）. Three cases were missdiagnosed, resulting a misdiagnose rate of 4. 3% （3/69） . Ultrasonic diagnosis rate was 95.6% during the first 28 weeks of gestation and turned 75.0% afterwards with significant differences （ X^2 = 4. 603, P 〈 0. 05 ） . Conclusion The ultrasound diagnosis of velamentous umbilical cord insertion, with a high diagnose rate during the first 28 weeks of gestation, is of great importance in providing guidance for clinical treatment and reducing perinatla death.