超声诊断不同类型前置胎盘与妊娠结局的相关关系

Study on the relationship between ultrasonographic diagnosis for different types of placenta praevia and outcome of pregnancy

目的探讨超声诊断不同类型前置胎盘与妊娠结局的相关关系。方法对50例经临床手术确诊的前置胎盘患者分别行腹部超声诊断与会阴部超声诊断,比较两种方法诊断不同类型前置胎盘与手术诊断符合率,并分析不同类型前置胎盘与妊娠结局之间的关系。结果与经腹部超声诊断的完全性、部分性及边缘性前置胎盘病例数与手术证实诊断符合率分别为72.22%,78.57%,77.78%;经会阴部超声诊断的完全性、部分性及边缘性前置胎盘病例数与手术证实诊断符合率为88.89%,92.86%,100%。经会阴部超声诊断前置胎盘准确率高于经腹部超声,差异具有统计学意义(P<0.05)。完全性前置胎盘发生胎盘粘连、胎盘植入、产后出血及子宫切除的比率高于部分性及边缘性前置胎盘组,差异均具有统计学意义(P<0.05)。完全性前置胎盘组围生儿窒息、早产率、病死率高于部分性组及边缘性组,Apgar评分较低,差异均具有统计学意义(P<0.05)。结论经会阴部超声诊断前置胎盘较经腹部超声诊断价值更高,适合用于诊断不同类型的前置胎盘;完全性前置胎盘具有更差的妊娠结局,应加强对该类型前置胎盘患者产前监护与保健。

Objective To explore the relationship between ultrasound diagnosis for different types of placenta previa and outcome of pregnancy. Methods Fifty patients clinically diagnosed as placenta previa were detected by abdominal ultrasound and perineal ultrasound,and the coincidence rate of placenta previa diagnosed by ultrasound and surgical diagnosis was compared,and the relationship between different types of placenta previa and outcome of pregnancy had been analyzed. Results The coincidence rates of placenta praevia partialis,marginal placenta praevia and complete placenta praevia by abdominal ultrasound diagnosis and surgery confirmed diagnosis were 72. 22%,78. 57% and 77. 78%respectively. The coincidence rates of placenta praevia partialis,marginal placenta praevia and complete placenta praevia in diagnosis of perineum ultrasound and surgery confirmed diagnosis were 88. 89%,92. 86% and 100% respectively. The difference in accuracy of diagnosis of placenta previa between these 2 methods was statistically significant（ P〈0. 05）. Complete placenta previa with placenta conglutination in comparison with placenta praevia partialis and marginal placenta praevia,placenta increta,would increase the probability of postpartum hemorrhage and hysterectomy,and the differences was statistically significant（ P〈0. 05）. The occurrence of asphyxia in perinatal infant,premature birth rate and mortality in 3 perinatal stages of complete placenta previa group were higher than those with partialis or marginal placenta praevia groups,with lower Apgar scores,and the differences was statistically significant（ P〈0. 05）. Conclusion Perineal ultrasound diagnosis of placenta previa in comparison with abdominal ultrasound has higher value,and it is suitable for the diagnosis of different types of placenta previa. Patients with complete placenta previa have poorer outcome of pregnancy,hence its prenatal care and health care should be strengthened.