经阴道超声联合经腹部超声对凶险性前置胎盘的诊断价值分析

Diagnostic value of transvaginal ultrasonography combined with transabdominal ultrasonography in dangerous placenta previa

目的:探讨经阴道超声联合经腹部超声对凶险性前置胎盘(Permicious Placenta Previa,PPP)的诊断价值。方法:选取2021年1月至2023年1月期间本院产科收治的疑似PPP患者98例作为研究对象,均行经腹部超声、经阴道超声检查,分娩后均进行病理检查。以病理结果为“金标准”,对比经腹部、经阴道超声检查结果与病理结果,对比联合检查结果与病理结果,对比经腹部、经阴道及联合检查诊断效能。结果:98例PPP疑似患者分娩后,经病理诊断PPP71例,非PPP27例,经阴道超声诊断真阳性55例,假阳性10例,假阴性16例,真阴性17例,诊断灵敏度为77.46%、特异度为62.96%、准确率为73.47%;经腹部超声诊断真阳性54例,假阳性9例,假阴性17例,真阴性18例,诊断灵敏度为76.06%、特异度为66.67%、准确率为73.47%;经腹部、经阴道超声联合诊断真阳性66例,假阳性4例,假阴性5例,真阴性23例,诊断灵敏度为92.96%、特异度为85.19%、准确率为90.82%,且联合诊断准确度、灵敏度、阴性预测值高于两项检查单独诊断,漏诊率低于单独诊断(P<0.05)。结论:经腹部、经阴道超声联合检查对PPP具有较高诊断价值,优于两项检查单独诊断,可作为临床诊断PPP的有效检查方式。

Objective:To evaluate the diagnostic value of transvaginal ultrasonography combined with transabdominal ultrasonography in Permicious Placenta Previa(PPP).Methods:Atotal of 98 suspected PPP patients admitted to the obstetrics department of our hospital from January 2021 to January 2023 were selected as the study objects.All of them underwent transabdominal ultrasound and transvaginal ultrasound,and pathological examinations were performed after delivery.With pathological results as the"gold standard",the results of transabdominal and transvaginal ultrasound were compared with pathological results,the results of combined examination were compared with pathological results,and the diagnostic efficacy of transabdominal,transvaginal and combined examination was compared.Results:After delivery of 98 suspected PPP patients,71 cases of PPP were pathologically diagnosed,27 cases of non-PPP,55 cases of true positive,10 cases of false positive,16 cases of false negative and 17 cases of true negative diagnosed by transvaginal ultrasonography.The diagnostic sensitivity was 77.46%,the specificity was 62.96%and the accuracy was 73.47%.There were 54 true positive cases,9 false positive cases,17 false negative cases and 18 true negative cases.The diagnostic sensitivity,specificity and accuracy were 76.06%,66.67%and 73.47%respectively.There were 66 true positive cases,4 false positive cases,5 false negative cases and 23 true negative cases diagnosed by combined abdominal and transvaginal ultrasonography.The diagnostic sensitivity was 92.96%,the specificity was 85.19%and the accuracy was 90.82%.Moreover,the accuracy,sensitivity and negative predictive value of combined diagnosis were higher than those of the two examinations alone.The rate of missed diagnosis was lower than that of single diagnosis(P<0.05).Conclusion:The combined examination of transabdominal and transvaginal ultrasound has high diagnostic value for PPP,which is better than the two examinations alone,and can be used as an effective examination method for clinical diagnosis of PPP.