产科中超声诊断妊娠晚期帆状胎盘的应用价值分析

Value of ultrasound in diagnosis of velum placenta in late pregnancy

目的探究产科中超声诊断妊娠晚期帆状胎盘的应用价值。方法选择76例帆状胎盘患者为观察组,按照孕周不同分为中期妊娠组(30例,孕周14~27周)、晚期妊娠组(46例,孕周28-41周)。另选择同期50例健康妊娠晚期分娩产妇为健康组。比较不同孕周帆状胎盘检出情况、晚期妊娠组与健康组妊娠结局,同时分析妊娠晚期组帆状胎盘影像学特征表现。结果妊娠晚期组帆状胎盘检出率60.87%低于妊娠中期组90.00%,差异有统计学意义(P<0.05)。妊娠晚期组不良妊娠结局发生率21.74%高于健康组6.00%,差异有统计学意义(P<0.05)。超声检查可见脐带根部入口距离胎盘较远,脐血管走向位于胎膜上方,并延伸至胎盘,合并血管前置时脐带根部入口可跨越宫颈内口位于胎膜上方,以脐动脉血流频谱为主。结论帆状胎盘可导致不良妊娠结局,为此进行超声检查,通过观察脐带、脐血管走行及宫颈内口等影像学特征表现,判断帆状胎盘,以指导采取干预措施。

Objective To explore the value of ultrasonography in the diagnosis of velum placenta in late pregnancy.Methods 76 patients with placenta sailiata were selected as the observation group,and divided into two groups according to different gestational weeks:second trimester group(30 cases,gestational weeks 14-27 weeks)and third trimester group(46 cases,gestational weeks 28-41 weeks).Another 50 healthy women in the third trimester were selected as the healthy group.The detection of sailiform placenta at different gestational stages,the pregnancy outcome between the third trimester group and the healthy group were compared,and the imaging characteristics of sailiform placenta in the third trimester group were analyzed.Results The detection rate of sailifonn placenta in the third trimester group was 60.87%lower than that in the second trimester group 90.00%,and the difference was statistically significant(P<0.05).The incidence of adverse pregnancy outcome in the third trimester group was 21.74%higher than that in the healthy group(6.00%),and the difference was statistically significant(P<0.05).Ultrasound examination showed that the entrance of the umbilical cord root was far away from the placenta,and the umbilical cord blood duct was located above the fetal membrane and extended to the placenta.When combined with vascular preposition,the entrance of the umbilical cord root could cross the inner cervical opening and located above the fetal membrane,and the blood flow spectrum of the umbilical artery was the main one.Conclusion Velum placenta can lead to adverse pregnancy outcomes.Therefore,ultrasound examination should be carried out to determine velum placenta by observing the imaging features of umbilical cord,umbilical blood vessel and cervical internal orifice,so as to guide the intervention measures.