经腹联合经会阴彩色多普勒超声对凶险型前置胎盘产前诊断的价值

Analysis value of prenatal diagnosis of perilous placenta previa via abdominal combined transperineal color Doppler ultrasound

目的:探讨经腹联合经会阴彩色多普勒超声(彩超)对凶险型前置胎盘的产前诊断价值。方法 :选取凶险型前置胎盘疑似孕妇86例,均于产前接受经腹联合经会阴彩超检查,对比单纯经腹彩超及两者联合检测结果。结果:86例经产后病理证实为凶险型前置胎盘67例。产前单纯经腹彩超的诊断符合率为82.09%(55/67);产前经腹联合经会阴超声的诊断符合率为97.01%(65/67),差异有统计学意义(P<0.05)。产前单纯经腹彩超的诊断灵敏度、阳性预测值均显著低于两者联合(均P<0.05)。结论:经腹联合经会阴超声检查可显著提高凶险型前置胎盘的检出率,降低误诊及漏诊率,临床诊断价值较高,但其对小范围粘连性胎盘的诊断具有局限性。

Objective：To explore the value of transabdominal combined transperineal color Doppler ultrasound in prenatal diag- nosis of dangerous placenta previa. Methods：Eighty-six pregnant women suspected with placenta previa were selected. All pa- tients underwent transabdominal combined transvaginal ultrasonography examination before delivery,compared with transabdominal uhrasonography and postpartum pathological examination. And the results of joint testing. Results：All 86 cases of pregnant women were confirmed as 67 cases of dangerous placenta previa during postpartum pathology. The diagnostic rate of prenatal simple abdominal ultrasound was 82.09% （55/67） ;the diagnostic rate of prenatal abdominal combined perineal ultrasonography was 97.01% （65/67）. The difference between the two groups was statistically significant （P〈0.05）. The sensitivity and positive predictive value of prenatal simple abdominal ultrasound diagnosis were significantly lower than those of prenatal abdominal combined perineal ultrasound. The difference between the two groups was statistically significant （P〈0.05）. Conclusion：The use of transabdominal combined perineal uhrasonography for pregnant women with dangerous placenta previa can significantly in- crease the diagnostic detection rate,reduce misdiagnosis and missed diagnosis rate,and have higher clinical diagnostic value. However,there are still missed cases,which have limitations on the diagnosis of small-area adhesion placenta.