早期流产患者子宫底蜕膜的超声表现

Sonographic Study of Decidua Basalis in Early Pregnancy Loss

目的：探讨早孕期胚胎停止发育及流产患者底蜕膜层的超声表现。方法：回顾152例妊娠4。12周患者的超声声像图，其中旱孕期流产117例，妊娠足月者35例。对比妊娠足月及早孕期流产患者底蜕膜层的厚度及回声强度。结果：（1）与正常孕妇相比，在第5-6周流产患者，底蜕膜相对变薄。但随着时间的推移，仍然可以保持其完整性，并且回声均匀；（2）在早孕晚期流产的患者，底蜕膜层的厚度没有表现出增长的趋势；（3）在胚胎死亡之前及之后不久，蜕膜层较正常妊娠回声增强。之后胚胎解体，底蜕膜层变得难以辨认。结论：在早孕期流产患者底蜕膜层超声表现与正常妊娠患者存在差异。

Objective： To describe the sonographic findings in the decidua basalis layer in spontaneous early pregnancy loss and to compare them with those in normal pregnancy. Methods： We reviewed scans at 4-12 weeks＇ gestation from 117 patients who miscarried clinically at less than 13 weeks＇ gestation and scans also at 4-12weeks from 35 patients who had normal uncomplicated term pregnancies. The thickness and echogenicity of the decidua basalis layer were compared between pregnancies which suffered early loss and normal controls. Results：Relative thinning of the decidua basalis was observed in cases of early pregnancy loss from 5-6 weeks onwards when compared with normal pregnancies, but the uniformity and echogenicity of the layer appeared to be relatively better preserved with time.In embryonic pregnancies that subsequently miscarried,the decidua basalis did not show the rising trend in thickness that was observed in normal pregnancies.Shortly before and after embryonic demise, the decidua appeared relatively more echogenic compared with that in normal pregnancy. Embryonic demise was followed by disorganization of the decidual layer, which became difficult to recognize.Conclusions：The decidua basalis layer in pregnancies that were destined to miscarry in the first trimester differs sonographically from that in normal pregnancies.