早孕期绒毛膜隆起的超声表现及临床意义

Ultrasonic manifestations and clinical significance of chorionic bump in first-trimester pregnancy

目的探讨早孕期绒毛膜隆起的超声特点及其临床意义。方法回顾性分析在我院行早孕期经阴道超声检查的孕妇33 691例,其中绒毛膜隆起60例,剔除失访病例,共38例纳入绒毛膜隆起组;绒毛膜下血肿2257例,随机抽取其中365例,剔除失访病例后,共220例纳入绒毛膜下血肿组;从余下正常孕妇中随机抽取365例,剔除失访病例后,共235例纳入正常早孕组;比较各组超声图像特点;追踪绒毛膜隆起和绒毛膜下血肿孕妇妊娠结局,分析绒毛膜隆起对妊娠预后的影响。结果绒毛膜隆起表现为妊娠早期由底蜕膜面绒毛膜向妊娠囊内的局部不规则凸起,内无血流信号。38例绒毛膜隆起组中,8例胚胎停育;220例绒毛膜下血肿组中,17例胚胎停育;235例正常早孕组中,21例胚胎停育;各组胚胎停育发生率分别为21.05%、7.72%及8.93%;绒毛膜隆起组胚胎停育发生率高于绒毛膜下血肿组及正常早孕组,差异均有统计学意义(P=0.010、0.025);绒毛膜下血肿组胚胎停育发生率与正常早孕组比较,差异无统计学意义(P=0.641)。结论超声对早孕期诊断绒毛膜隆起有一定的临床应用价值。早孕期绒毛膜隆起可影响胎儿发育,造成停育。

Objective To investigate the ultrasonic manifestations and clinical significance of chorionic bump in first-trimester pregnancy.Methods The ultrasonographic characteristics of 33 691 patients detected by transvaginal ultrasonography in early pregnancy were retrospectively analyzed. 38 cases were included in chorionic bump group after eliminating missing cases. 220 cases were included in subchorionic hematoma group after eliminating miss cases from 365 subchorionic hematoma patients and 235 cases were included into normal group after eliminating miss cases from 365 normal patients. The ultrasonic characteristics were compared with those of subchorionic hematoma patients and normal early pregnant women.The pregnancy outcome was followed up and the effect of chorionic bump on the prognosis of pregnancy was analyzed.Results The ultrasnoic features of chorinic bump in early pregnancy was a local irregular bulge in the pregnancy sac with no signal of blood flow. Among 38 cases of chorionic bump,8 cases of embryonic abortion were detected.Among 220 patients with subchorionic hematoma,17 cases had embryonic abortion.Among 235 cases of normal early pregnancy,21 cases had embryo sterilization.The incidence of embryo arrest were 21.05%,7.72% and 8.93%,respectively.The incidence of embryo arrest in chorionic bump group was higher than that in subchorionic hematoma group and normal early pregnancy group(P=0.010,0.025).There was no significant difference in the incidence of embryo abortion between the subchorionic hematoma group and the normal early pregnancy group(P=0.641).Conclusion Ultrasound has certain clinical value in the diagnosis of chorionic bump in early pregnancy.The chorionic bump has a great impact on the development of the fetus,which can cause embryo development arrest.