经腹部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临床价值

Clinical value of transabdominal combining transperineal color Doppler ultrasound in prenatal diagnosis of dangerous placenta previa

目的 探讨经腹部联合经会阴彩色多普勒超声在诊断凶险型前置胎盘中的应用效果。方法 回顾性分析2013年8月至2018年8月本院收治的98例疑似凶险型前置胎盘孕妇的影像学资料,对所有患者分别采用经腹部彩色多普勒超声检查与经腹部联合经会阴彩色多普勒超声检查,并将两种检查结果与产后手术病理结果对比。结果 98例疑似凶险型前置胎盘孕妇中,经术后病理检查共确诊80例,单独经腹部检查确诊63例,经腹部联合经会阴检查确诊77例。经腹部超声检查特异度为55.56%(10/18),经腹部联合经会阴检查特异度为66.67%(12/18),两种检查方式特异度相比,差异无统计学意义(P >0.05);经腹部联合经会阴检查敏感度及准确度分别为96.25%(77/80)、90.82%(89/98),均高于经腹部超声检查的78.75%(63/80)、74.49%(73/98),差异有统计学意义(均P<0.05)。结论 对凶险型前置胎盘孕妇采用经腹部联合经会阴彩色多普勒超声检查,可有效提高诊断准确性,从而减少误诊、漏诊,且有利于为临床诊治提供可靠参考信息。

Objective To investigate the effect of transabdominal combining transperineal color Doppler ultrasound in the diagnosis of dangerous placenta previa.Methods The imaging data of 98 pregnant women with suspected dangerous placenta previa admitted to our hospital from August 2013 to August 2018 were retrospectively analyzed.Transabdominal color Doppler ultrasonography and transabdominal combining transperineal color Doppler ultrasonography were used in all the patients,and the results were compared with the postpartum pathological results.Results Among the 98 cases,80 cases were confirmed by postoperative pathological examination,63 cases by abdominal examination,and 77 cases by abdominal combining transperineal examination;there was no statistical difference in specificity between the two examinations(P >0.05).The sensitivity and accuracy by transabdominal combining transperineal color Doppler ultrasound were 96.25%(77/80)and 90.82%(89/98),and those by transabdominal color Doppler ultrasonography 78.75%(63/80)and 74.49%(73/98),with statistical differences(both P<0.05).Conclusion Transabdominal combining transperineal color Doppler ultrasonography can effectively improve the diagnostic accuracy of dangerous placenta previa,and reduce the occurrence of misdiagnosis and missed diagnosis,and is conducive to providing reliable reference information for clinical diagnosis and treatment.