孕晚期胎盘前置合并胎盘植入产妇彩色多普勒超声检查及其诊断

Color Doppler Ultrasound Examination and Diagnosis of Placenta Previa Complicated with Placenta Implantation in Late Pregnancy

目的探讨彩色多普勒超声检查孕晚期胎盘前置合并胎盘植入产妇的诊断价值。方法选择2016年12月至2018年12月本院收治的孕晚期胎盘前置产妇患者250例。对250例患者行彩色多普勒超声检查,诊断有无胎盘植入,最后以手术结果及病理报告为诊断金标准,计算彩色多普超声检查对诊断孕晚期产妇前置胎盘合并胎盘植入的诊断符合率、正确率、敏感度及特异度。结果250例孕晚期产妇经彩色多普勒超声检查诊断胎盘前置合并胎盘植入21例,二维超声图像提示胎盘后间隙消失,胎盘与子宫肌层之间的连续低回声带中断,CDFI提示胎盘实质内腔隙性血流,PW提示胎盘植入部分血流频谱信号异常。妊娠结局确诊合并胎盘植入19例,其中3例漏诊,2例误诊。胎盘植入诊断符合率为90.5%,准确率为98.0%,敏感度为86.4%,特异度为99.1%。结论对孕晚期产妇行彩色多普勒超声检查前置胎盘合并胎盘植入,超声图像特异性强,诊断准确率高,操作简单便捷,可为产前诊断提供可靠依据。

Objective To evaluate the diagnostic value of color Doppler ultrasonography in pregnant women with placenta previa and placenta implantation in late pregnancy.Methods 250 cases of placenta previa in late pregnancy were selected from December 2016 to December 2018.250 patients were examined by color Doppler ultrasonography to diagnose placenta implantation.Finally,the diagnostic accordance rate,accuracy rate,sensitivity and specificity of color Doppler ultrasonography in the diagnosis of placenta previa complicated with placenta implantation in late pregnant women were calculated based on the diagnostic gold standard of surgical results and pathological reports.Results In 250 late pregnant women,21 cases of placenta previa combined with placenta implantation were diagnosed by color Doppler ultrasonography.Two-dimensional ultrasound images showed that the posterior placental space disappeared,the continuous hypoechoic cords between the placenta and the uterine myometrium were interrupted,CDFI indicated the blood flow in the parenchymal lacuna of the placenta,and PW indicated the abnormal blood flow spectrum signal in the placenta implantation.19 cases were diagnosed with placenta implantation in pregnancy outcome,of which 3 cases were missed and 2 cases were misdiagnosed.Placenta implantation diagnosis rate was 90.5%,the accuracy rate was 98%,the sensitivity was 86.4%,and specificity was 99.1%.Conclusion Color Doppler ultrasound examination of placenta previa combined with placenta implantation for women in late pregnancy has strong specificity,high diagnostic accuracy,simple and convenient operation,which can provide reliable basis for prenatal diagnosis.