超声诊断妊娠晚期胎盘前置类型及其与围生期结局的关系

Ultrasound diagnosis types of placenta previa during the late pregnancy and its relationship with the perinatal outcome

目的探讨超声诊断妊娠晚期前置胎盘（PP）类型与围生期结局的关系。方法对170例PP孕妇和同期行超声检查的170例健康孕妇的临床资料进行回顾性分析，对比研究与PP相关的危险因素，比较超声诊断不同类型PP的围生期结局。结果170例PP孕妇经超声诊断后，分为完全性PP82例，部分性PP36例，边缘性PP32例，低置胎盘20例。PP孕妇年龄330岁所占比例、产次、孕次、流产次数和剖宫产次数均高于健康孕妇[59．4％（101／170）比40．0％（68／170）、（1．5±0．6）次比（1.3±0．4）次、（2．4±0．5）次比（1．7±0．1）次、（1．7±0．1）次比（1．1±0．3）次、（1.3±0．3）次比（1．0±O．1）次]，差异均有统计学意义（P〈0．01）。完全性PP孕妇的产次、孕次、流产次数、剖宫产次数、年龄及剖宫产、产后出血、胎盘粘连、早产、新生儿体重〈2．5kg、5minApgar评分〈7分的发生率均高于部分性PP、边缘性PP和低置胎盘孕妇，差异均有统计学意义（P〈0．01）。结论超声可动态观察PP的发展过程，产科高危因素与PP严重程度有一定相关性，应引起重视，及早干预，可改善母儿预后。

Objective To investigate ultrasound diagnosis different types of placenta previa （PP） during the late pregnancy and its relationship with the perinatal outcome. Methods The clinical data of 170 pregnant women with PP and 170 healthy pregnant women who underwent ultrasound were retrospectively analyzed. PP-related risk factors were analyzed, the perinatal outcome of different types of PPwere compared. Results Among PP pregnant women,complete PP was in 82 cases,partial PP was in 36 cases, marginal PP was in 32 cases, low-lying placenta was in 20 cases. The rate of age ≥ 30 years old, parity, gravidity, the number of abortion and the number of cesarean section in PP pregnant women were significantly higher than those in healthy pregnant women [59.4%（101/170） vs. 40.0%（68/170）, （1.5 ± 0.6） times vs. （ 1.3 ± 0.4） times, （2.4 ± 0.5 ） times vs. （ 1.7 ± 0.1 ） times, （ 1.7 ± 0.1 ） times vs. （ 1.1 ± 0.3 ） times, （ 1.3 ± 0.3 ） times vs. （ 1.0 ± 0.1 ） times, P 〈 0.01 ]. Parity, gravidity, the number of abortion, the number of cesarean section, age, and the incidence rate of cesarean section, postpartum hemorrhage, placental adherence, premature delivery, neonatal weight 〈 2.5 kg, 5 min Apgar score 〈 7 scores in complete PP pregnant women were significantly higher than those in partial PP, marginal PP and low-lying placenta pregnant women （P 〈 0.01 ）. Corldusions Ultrasound can dynamically observe the development process of the PP. There is a certain correlation with the severity of risk factors of PP, early intervention can improve the prognosis.