产前超声检查对前置胎盘合并胎盘植入的诊断

Diagnostic Value of Prenatal Ultrasonography on Placenta Previa with Placenta Accreta

本研究探讨产前超声诊断前置胎盘并胎盘植入的临床价值。选取72例前置胎盘孕妇作为临床研究对象,均接受产前超声检查,其中37例孕妇前置胎盘合并胎盘植入(植入组)、35例孕妇仅前置胎盘(对照组),对比两组超声声像特征及超声评分的差异,分析超声评分诊断前置胎盘合并胎盘植入的价值。植入组的胎盘组织厚度≥3.0 cm患者比例、胎盘实质内隐窝检出率、胎盘后低回声带完整的患者占比、子宫基层最薄处厚度≤1.0 mm患者占比、膀胱面粗糙患者占比、胎盘基底部血流信号规则的患者占比、宫颈及周边血流信号检出率均显著高于对照组(P<0.05);植入组的产前超声评分显著高于对照组(P<0.05);产前超声评分诊断前置胎盘合并胎盘植入的AUC值为0.944。前置胎盘合并胎盘植入孕妇产前超声具有胎盘组织厚度增加、发生胎盘实质内隐窝等典型特征,采用产前超声评分对前置胎盘并发植入进行诊断具有较高的灵敏度和特异度。

This study investigated the clinical value of prenatal ultrasonography in the diagnosis of placenta previa with placenta accreta.Seventy-two pregnant women with placenta previa were selected as clinical research subjects,and all of them unwent prenatal ultrasound examination.Among them,37 pregnant women with placenta previa combined with placenta accreta(inplantation group)and 35 pregnant women with placenta previa only(control group)were compared.Analyzed the differences on sonographic features and ultrasonic scores of the two groups,and the value of the ultrasonic scores in the diagnosis of placenta previa combined with placenta accreta.In implantation group,the proportion of patients with placental tissue thickness≥3.0 cm,the detection rate of recesses in placental parenchyma,the proportion of patients with intact retroplacental hypoechoic zone,the proportion of patients with the thickness of the thinnest part of the uterine basal layer≤1.0 mm,and the patients with rough bladder surface,the proportion of patients with regular blood flow signals at the base of the placenta,and the detection rate of cervical and peripheral blood flow signals were all higher than those of the control group(P<0.05).The prenatal ultrasound score of the implantation group was significantly higher than that of the control group(P<0.05).The AUC value of the prenatal ultrasound score for the diagnosis of placenta previa combined with placenta accreta was 0.944.Prenatal ultrasound in pregnant women with placenta previa and placenta accreta has typical features such as increased placental tissue thickness and occurrence of placental intraparenchymal recesses.Prenatal ultrasound scoring has high sensitivity and specificity for the diagnosis of placenta previa complicated with accreta.