产前超声检查诊断脐血管前置的临床应用价值

Prenatal ultrasonography in diagnosis of the umbilical vasa previa

目的探讨产前超声检查在脐血管前置诊断中的价值及临床意义。方法回顾性分析19例临床诊断脐血管前置孕妇的病历资料,总结其二维及彩色多普勒超声声像图特点,并与产后结果比较。结果 19例脐血管前置患者中,包括11例脐带帆状附着型,5例副胎盘型,2例双叶胎盘型,1例脐带胎盘边缘附着型。16例患者的超声诊断结果与临床病理结果一致,超声诊断准确率为84.21%,漏、误诊3例。典型的图像特征是:宫颈内口上方横切面呈圆形无回声,纵切面呈条管状无回声,沿宫颈内口或接近宫颈内口的胎膜下穿行,CDFI检查探及血流信号充盈,PW检查血管搏动与胎心率一致。结论产前超声检查能准确诊断脐前置血管,降低围生儿死亡率,具有重要的临床应用价值。

Objective To explore the clinical value of prenatal ultrasonography in diagnosis of umbilical vasa previa. Methods 19 patients with clinical diagnosis of umbilical vasa previa were involved in the present study. The features of two-dimensional and color Doppler sonographic were observed. Results Of 19 patients with umbilical vasa previa, There were 11 cases with velamentous insertion of umbilical cord, 5 cases with accessory placenta, 2 cases of placental Futaba, and 1 case of umbilical cord attached to the edge of the placenta. The pre-diagnostic ultrasound results of 16 cases of patients were consistent with the results of clinical pathology. The ultrasound diagnostic accuracy was 84.21%. The vasa previa was characterized by a CDFI： Above the cervix circular cross section, no echo, echo-free longitudinalsection tubular bars along the cervix or lower near the cervix of the membranes, CDFI inspection probe and flow signals filling ,PW check pulsatility consistent with the fetal heart rate. Conclusion Prenatal ultrasonography can accurately screen out of umbilical vasa previa, thereby reducing perinatal mortality in children,with high clinical application.