超声连续追踪对凶险型前置胎盘伴胎盘植入的早期诊断价值

The Value of Ultrasound Continuous Tracking in the Early Diagnosis of Dangerous Placenta Previa with Placenta Implantation

目的研究超声连续追踪对凶险型前置胎盘伴胎盘植入的早期诊断价值。方法选取2019年4月-2021年4月我院接诊62例凶险型前置胎盘患者为观察组,其中伴胎盘植入22例,未伴胎盘植入40例,并选取同期我院接诊的60例非凶险型前置胎盘孕妇为对照组。比较两组孕妇不同孕囊位置情况、不同孕周孕妇与胎盘距宫颈内口距离情况、孕22~26周孕妇胎盘距宫内口<50 mm中前壁胎盘与后壁胎盘发生情况、孕30~32周前壁和后壁胎盘孕妇不同胎盘类型发生情况。结果观察组孕妇孕早期孕囊位置在宫腔下1/2发生率大于对照组,差异有统计学意义(P<0.05);观察组孕14~20周胎盘距宫内口<30 mm发生率大于对照组,孕22~26周胎盘距宫内口<50 mm发生率大于对照组,差异有统计学意义(P<0.05);伴胎盘植入孕妇前壁胎盘发生率高于未伴胎盘植入孕妇及对照组,后壁胎盘发生率低于未伴胎盘植入孕妇及对照组,差异有统计学意义(P<0.05);孕30~32周,前壁胎盘孕妇中央型胎盘发生率高于后壁胎盘,部分型、边缘型胎盘发生率均低于后壁胎盘,差异有统计学意义(P<0.05)。结论连续超声追踪可显示不同孕期孕囊位置、胎盘距宫颈内口距离、胎盘位置以及胎盘类型,为凶险型前置胎盘伴胎盘植入诊断提供可靠的参考依据,有助于临床早期防范,改善妊娠结局。

Objective To study the value of ultrasound continuous tracking in the early diagnosis of dangerous placenta previa with placenta implantation.Methods A total of 62 patients with pernicious placenta previa admitted to our hospital from April 2019 to April 2021 were selected as observation group,including 22 cases with placenta implantation and 40 cases without placenta implantation,and 60 pregnant women with non-pernicious placenta previa admitted to our hospital during the same period were selected as control group.The incidences of different placenta types in pregnant women with different gestational sac positions,distances between pregnant women with different gestational weeks and placentas from the cervical orifice,placentas from pregnant women with gestational weeks 22-26 from the cervical orifice<50 mm in the anterior and posterior placentas,and pregnant women with gestational weeks 30-32 from the anterior and posterior placentas were compared between the two groups.Results The incidence of 1/2 of the gestational sac position under the uterine cavity in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The incidence of placental distance<30 mm at 14-20 weeks of pregnancy in the observation group was higher than that in the control group,and the incidence of placental distance<50 mm at 22-26 weeks of pregnancy was higher than that in the control group,the difference was statistically significant(P<0.05).The incidence of anterior placenta in pregnant women with placenta implantation was higher than that in pregnant women without placenta implantation and the control group,and the incidence of posterior placenta in pregnant women with placenta implantation was lower than that in pregnant women without placenta implantation and the control group,and the difference was statistically significant(P<0.05).At 30-32 weeks of gestation,the incidence of central placenta in pregnant women with anterior placenta was higher than that of posterior placenta,and the incidence of partial and marginal placenta was lower than that of posterior placenta,the difference was statistically significant(P<0.05).Conclusion Continuous ultrasound tracking can show the position of gestational sac,the distance between placenta and cervical orifice,the position of placenta and the type of placenta in different pregnancy,and provide reliable reference for the diagnosis of dangerous placenta previa with placenta implantation,which is helpful to early clinical prevention and improve pregnancy outcomes.