宫颈受累的超声征象对前置胎盘伴有胎盘植入性疾病的临床分级诊断及不良妊娠结局的预测价值

The Prediction Value of Ultrasound Signs of Cervical Involvement in the Clinical Grading Diagnosis of Placenta Previa with Placental Accreta Spectrum and Adverse Pregnancy Outcome

目的:研究宫颈受累的超声征象对前置胎盘伴有胎盘植入性疾病(placenta accreta spectrum,PAS)的临床分级诊断及不良妊娠结局的预测价值。方法:选取2020年6月─2022年6月黄冈市妇幼保健院收治的80例诊断为前置胎盘伴有PAS患者作为研究对象,根据患者产前超声检查结果中有无宫颈受累征象分为观察组(有宫颈受累症状,n=10)和对照组(无宫颈受累征象,n=70)。比较两组临床资料、分级诊断结果及妊娠结局差异。结果:两组年龄、末次超声检查孕周、宫腔操作史比较,差异无统计学意义(P>0.05);两组剖宫产次数比较,差异有统计学意义(P<0.05)。两组PAS分级比较,差异无统计学意义(P>0.05);两组手术诊断结果比较,差异有统计学意义(P<0.05)。观察组子宫切除率高于对照组,分娩出血量多于对照组,差异有统计学意义(P<0.05)。结论:宫颈受累的超声征象对前置胎盘伴有PAS患者的PAS类型及患者不良妊娠结局的发生有一定预测价值,但对患者PAS等级无预测价值。

Objective:To study the prediction value of ultrasound signs of cervical involvement in the clinical grading diagnosis of placenta previa with placenta accreta spectrum(PAS)and adverse pregnancy outcome.Method:A total of 80 patients diagnosed with placenta previa with PAS admitted to Huanggang Maternal and Child Health Hospital from June 2020 to June 2022 were selected as the study objects.According to the results of prenatal ultrasound examination,patients were divided into the observation group(with cervical involvement symptoms,n=10)and the control group(without cervical involvement symptoms,n=70).The clinical data,graded diagnosis results and pregnancy outcome were compared between the two groups.Result:There were no significant differences in age,gestational week of the last ultrasound examination and uterine cavity operation history between the two groups(P>0.05).There was significant difference in the number of cesarean section between the two groups(P<0.05).There was no significant difference in PAS classification between the two groups(P>0.05).The difference of surgical diagnosis between the two groups was statistically significant(P<0.05).The hysterectomy rate in the observation group was higher than that in the control group,and delivery blood loss was more than that in the control group,and the differences were statistically significant(P<0.05).Conclusion:The ultrasonic signs of cervical involvement have certain predictive value for the type of PAS in patients with Placenta praevia and PAS and the occurrence of adverse pregnancy outcomes,but have no predictive value for the level of PAS in patients.