凶险性前置胎盘的产前超声诊断及临床意义

Prenatal Ultrasound Diagnosis and Clinical Significance of Sinister Placenta Previa

目的探析产前超声在凶险性前置胎盘诊断中的应用价值。方法回顾分析2018 年1—12 月本院接收的凶险性前置胎盘患者50 例,所有患者均接受产前超声检查,对比超声检查结果与病理检查结果。结果经超声检查前置胎盘伴植入47 例,假阳性3 例,符合率为94.00%。超声显示胎盘位于子宫前壁部位,其下缘位置局部或者全部覆盖于宫颈内口位置,原剖宫产瘢痕位置再次附着胎盘,大部分胎盘实质内腔隙血流,胎盘回声暗区厚度在1 cm 以上,血池较多,宫颈组织、子宫肌层与胎盘间界限模糊,子宫前壁原瘢痕位置肌层相对薄弱,大约0.2 ~ 0.5 cm,经彩色多普勒超声检查血流显像提示肌层内部存在丰富血流,其可以将胎盘垂直入侵子宫肌层血流信号清楚地显示出来。结论产前彩色多普勒超声具有较高的凶险性前置胎盘诊断符合率,其能够将孕产妇胎盘状况清楚地反应出来,以便更好的开展临床诊治。

Objective To explore the application value of prenatal ultrasound in the diagnosis of dangerous placenta previa. Methods A retrospective analysis of 50 patients with sinister placenta previa received from our hospital from January to December 2018, all patients underwent prenatal ultrasound examination, contrast ultrasound results and pathological findings. Results 47 cases of placenta previa were implanted with ultrasound, and 3 cases were false positive. The coincidence rate was 94.00%. Ultrasound showed that the placenta was located in the anterior wall of the uterus, and the position of the lower edge partially or completely covered the position of the internal cervix. The placenta of the original cesarean section reattached the placenta, and most of the placental parenchymal cavity blood flow, the thickness of the placental echo dark area was 1 cm. Above, there are more blood pools, and the boundary between the cervical tissue, the myometrium and the placenta is blurred. The muscle layer at the original scar of the anterior wall of the uterus is relatively weak, about 0.2~0.5 cm. The blood flow imaging is indicated by color Doppler ultrasonography. There is a rich blood flow inside the layer, which can clearly show the blood flow signal of the placenta vertically invading the myometrium. Conclusion Prenatal color Doppler ultrasound has a high diagnostic rate of risky placenta previa, which can clearly reflect the maternal placenta status, so as to better carry out clinical diagnosis and treatment.