阴道超声观测羊膜囊形态大小在早期妊娠中的诊断价值及应用前景

The value analysis of breast ultrasound combined with mammary duct endoscope examination in application of nipple discharge diseases an outlook to observation of shape and size of amniotic sac in early pregnancy by transvaginal ultrasonography and discussi

目的 探讨经阴道超声观测羊膜囊形态大小在早期妊娠中的诊断价值和应用前景.方法研究对象选2012年1～12月妊娠 6～10周经阴道超声检查的孕妇607例,追踪随访至妊娠28周,以妊娠 6～28周期间超声检查胚胎停育或自然流产的孕妇为异常妊娠组共149例,按照按妊娠结局分为先兆流产组和必然流产组,余下458例经超声检查胚胎正常发育的孕妇为正常妊娠组.采用流行病学巢氏病例对照研究方法,观察孕妇各项生命指标,应用经阴道超声观测妊娠囊及囊内容物（羊膜囊、卵黄囊及心管搏动）,重点观察羊膜囊是否显示及其形态、大小,测量羊膜囊直径,分析预测妊娠结局.结果 通过羊膜囊测值结果分析其形态特征,正常妊娠组和异常妊娠组妊娠的羊膜囊大小及形态,存在显著性差异（P〈0.05）.对比先兆流产和必然流产与羊膜囊分析关系显示比较无显著差异（P〉0.05）.说明超声显像与病理分析对胚胎发育停止类型的判定无差异,可通过超声准确判断胚胎停止发育类型.结论 经阴道超声检测早孕羊膜囊形态大小,结合HCG、孕酮等检验结果,可准确预测胚胎发育及妊娠结局,为临床指导治疗、降低流产率提供了有力参考.

Objective To explore the diagnostic value of amniotic sac observation by transvaginal uhrasonography in early pregnancy di- agnosis and analyze its developing trend and applied prospects. Methods The research subjects were 607 pregnant women who received trans- vaginal ultrasound examination in their 6 to 10 weeks gestation. We follow - up the 607 cases until pregnancy 28 weeks. There is a total number of 149 pregnant women in 6 -28 weeks gestation during ultrasound examination, which showed the embryo damage, or natural abortion for unu- sually gravid. According to the pregnancy outcome, the 149 pregnant women can be divided into two groups named threatening miscarriage group and the inevitable abortion group. The rest 458 pregnant women with ultrasound examination had normal development of embryos. All these women can be called normal pregnancy group. We adopt an epidemiological nest~ case control study method. Various life indexes of preg- nant women, gestational sac and their inside were observed. The emphasis was put in recording amniotic membrane capsule shape and size, header arm diameter, and etc, analyzing characteristics of amniotic sac and relationship between pregnancy outcome and abortion. Results Based on the measured values result of amniotic membrane, analyzing its morphological characteristics, this paper compares the life amniotic sac pregnancy outcome group size and shape differences between normal and abnormal gestation group, which were in the significant difference （ P 〈0.05 ）. Compare threatening miscarriage with inevitable abortion, amniotic membrane capsule analysis showed there were no significant differences between two groups （ P 〉 0.05 ）. Such research stated that when using ultrasonic imaging to figure out the type of embryo damage. The outcome is the same as the method of pathological analysis, so it would be reliable to use the ultrasound imaging when trying to determine the type of embryo damage. Conclusion By using transvaginal ultrasound to examine the size and shape of amniotic sac, together with exami- nation of HCG and pregnendione, we can accurately predict the outcome of pregnancy, fetal stop development type and characteristics, can pro- vide a powerful reference value to clinical treatment, which can help to reduce the miscarriage rate.