彩色多普勒超声对凶险性前置胎盘合并植入的诊断研究

Color Doppler Ultrasound for Diagnosis of Complicated Implantation of Placenta Previa

目的:探讨彩色多普勒超声对凶险性前置胎盘合并植入的诊断价值,并总结超声表现特征。方法:选取2017年1月~2019年10月在本院产前超声诊断疑似凶险性前置胎盘植入的40例患者,后经剖宫产术后证实为凶险性前置胎盘植入。术后收集患者的产前超声诊断资料,统计其与病理诊断符合率、漏诊率和误诊率。结果:40例患者剖宫产术中确诊为凶险性前置胎盘合并植入,其中4例产妇为穿透型胎盘。经腹联合经阴道超声诊断符合率(95.00%)显著高于经腹超声(70.00%)、经阴道超声(80.00%),差异具有统计学意义(P<0.05)。经腹联合经阴道超声诊断误诊率(17.50%、7/40)显著低于经腹超声(2.50%、1/40),差异具有统计学意义(P<0.05)。结论:凶险性前置胎盘合并植入的彩色多普勒超声诊断准确性较高,经腹联合经阴道超声诊断效果最为理想,可进一步结合超声表现特征提高诊断准确性。

Objective:To explore the diagnostic value of color Doppler ultrasound for dangerous placenta previa combined implantation,and to summarize the characteristics of ultrasound performance.Methods:From January 2017 to October 2019,40 patients with suspected dangerous placenta previa implantation diagnosed by prenatal ultrasound in our hospital were selected and confirmed as dangerous placenta previa implantation after cesarean section.The prenatal ultrasound diagnosis data of patients were collected after operation,and the coincidence rate,missed diagnosis rate and misdiagnosed rate with pathological diagnosis were counted.Results:40 patients were diagnosed with dangerous placenta previa combined with implantation during cesarean section,and 4 of them had penetrating placenta.The coincidence rate of transabdominal and transvaginal ultrasound diagnosis(95.00%)was significantly higher than that of transabdominal ultrasound(70.00%)and transvaginal ultrasound(80.00%),the difference was statistically significant(P<0.05).The misdiagnosis rate of transabdominal combined with transvaginal ultrasound diagnosis(17.50%,7/40)was significantly lower than that of transabdominal ultrasound(2.50%,1/40),the difference was statistically significant(P<0.05).Conclusion:The color Doppler ultrasound diagnosis of dangerous placenta previa combined with implantation is high,and the effect of transabdominal combined with transvaginal ultrasound is the most ideal,it can be further combined with the characteristics of ultrasound performance to improve the accuracy of diagnosis.