多种超声联合检查在胎盘植入诊断中的应用

Value of prenatal diagnosis of placenta accreta by combined multiple ultrasound inspection

目的:探讨多种超声联合检查在胎盘植入诊断中的意义。方法:通过对2011年1月—2015年1月我院收治的189例前置胎盘患者的临床资料、超声检查方法、超声表现等信息进行收集,根据是否合并胎盘植入,分为胎盘植入组和非胎盘植入组,分析经腹、经浅表、经阴道、结合三维能量多普勒检查在胎盘植入中的价值、声像图特点,漏、误诊的原因。结果:189例前置胎盘中,植入34例(粘连性胎盘7例,部分性胎盘植入18例,完全性胎盘植入9例)发生率18%(34/189);发现多种方法联合诊断的灵敏度和特异度较高(85.3%,99.4%);明显高于经腹(58.8%,96.1%)、经腹+浅表联合(64.7%,97.4%);多种(经腹+浅表+阴道+三维)联合方法的准确度达96.8%,明显高于经腹(89.7%)、经腹+浅表联合(91.5%)。结论:采用多种超声联合检查,避免了单一超声带来的局限性,可大大提高胎盘植入的诊断率。

Objective: To assess the value of prenatal diagnosis of placenta accreta by combined multiple ultrasound inspection. Methods: One hundred and eighty-nine cases of placenta prevail patients underwent combined multiple ultrasound inspection from January 2011 to January 2015 in our hospital, whose clinical data, ultrasonography and other information were collected, according to whether mergered with the placenta accreta, those patients were divided into placenta accreta group and non placenta accreta group, and the diagnosis value, sonographic features, misdiagnosed reasons of multiple methods(abdominal, superfical, vaginal, combined with three-dimensional power Doppler examination) in the placenta implants were analyzed. Results: There are 34 cases placenta accreta in 189 cases of placenta prevail, its incidence was 18%(34/189), including 7 cases of adhesive placenta, 18 cases of partial placenta accreta and 9 cases of complete placenta accreta. The sensitivity and specificity of the combined multiple methods was 85.3%, 99.4%; significantly higher than abdominal(58.8%, 96.1%),abdominal united superfical(64.7%, 97.4%). Accuracy of the combined multiple methods was 96.8%, significantly higher than the abdominal(89.7%), abdominal united superfical(91.5%). Conclusion: Using combined multiple ultrasound inspection could avoid the limitations of using a single ultrasound, and could greatly increase the accuracy of diagnosis of placenta accreta.