核磁共振成像应用于妊娠期凶险型前置胎盘的临床诊断价值及与妊娠结局的相关性研究

Clinical Value of Magnetic Resonance Imaging in the Diagnosis of Pernicious Placenta Previa During Pregnancy and Its Correlation with Pregnancy Outcome

目的探讨核磁共振成像应用于妊娠期凶险型前置胎盘(Pernicious Placenta Previa,PPP)的临床诊断价值及与妊娠结局的相关性。方法选取2013年1月至2018年12月于我院检查的疑似前置胎盘(Placenta Previa,PP)孕妇88例为研究对象。所有孕妇均行MRI检查。将经手术病理确诊的81例PP孕妇分为32例非凶险型PP作为对照组,49例PPP作为观察组。观察两组妊娠及胎儿结局,并分析MRI临床诊断价值。结果MRI诊断PP76例,手术病理确诊81例,准确率为93.83%。MRI诊断胎盘粘连31例,手术病理确诊37例,准确率为83.78%。MRI诊断胎盘植入8例,手术病理确诊14例,准确率为57.14%。MRI诊断胎盘穿透2例,手术病理确诊7例,准确率为28.57%。产后出血量、术中输血量及子宫切除率观察组均显著高于对照组,差异具有统计学意义(P<0.05),81例PP孕妇中仅对照组中1例成功分娩。早产儿率及窒息率观察组均显著高于对照组,差异具有统计学意义(P<0.05),而新生儿死亡率两组比较差异不具统计学意义(P>0.05)。结论MRI对PPP具有重要临床诊断价值,准确率较高,可作为产前胎盘植入的早期诊断标准。PPP能显著增加不良妊娠结局发生几率,而MRI能有效预防不良妊娠结局。

Objective To evaluate the clinical value of magnetic resonance imaging(MRI)in the diagnosis of Pernicious Placenta Previa(PPP)during pregnancy and its correlation with pregnancy outcome.Methods From January 2013 to December 2018,88 suspected pregnant women with Placenta Previa(PP)were selected.All pregnant women underwent MRI examination.Total 81 pregnant women with PP diagnosed by surgery and pathology were divided into 32 cases of non-dangerous PP as the control group and 49 cases of PPP as the observation group.Pregnancy and fetal outcomes were observed in both groups,and the clinical diagnostic value of MRI was analyzed.Results MRI diagnosed 76 cases of PP,and 81 cases were confirmed by surgical pathology with an accuracy rate of 93.83%.MRI diagnosed 31 cases of placental adhesions,and 37 cases were confirmed by surgical pathology with an accuracy rate of 83.78%.MRI diagnosed 8 cases of placental implantation,and 14 cases were confirmed by surgical pathology with an accuracy rate of 57.14%.MRI diagnosed 2 cases of placental penetration and 7 cases were confirmed by surgical pathology with an accuracy of 28.57%.Postpartum hemorrhage,intraoperative blood transfusion,and hysterectomy rate were significantly higher in the observation group than in the control group,and the differences were statistically significant(P<0.05).Only one of the 81 pregnant women with PP successfully delivered.The rates of preterm infants and asphyxia were significantly higher in the observation group than in the control group,the difference was statistically significant(P<0.05),while the difference in neonatal mortality between the two groups was not statistically significant(P>0.05).Conclusion MRI has important clinical diagnostic value for PPP,with high accuracy,and can be used as an early diagnostic standard for prenatal placenta implantation.Moreover,PPP can significantly increase the incidence of adverse pregnancy outcomes,and MRI can effectively prevent adverse pregnancy outcomes.