产前超声诊断前置胎盘并胎盘植入的价值

The Value of Prenatal Ultrasound in the Diagnosis of Placenta Previa and Placental Implantation

目的:分析对诊断前置胎盘并胎盘植入患者进行产前超声的价值。方法:本次试验选取南京市高淳人民医院产科在2021年11月~2023年2月就诊的84例前置胎盘并胎盘植入患者,对其均进行产前超声检查,与病理学诊断作对比,分析患者诊断结果、诊断效能、超声影像学特征、临床参数。结果:分析诊断结果,经病理学诊断阳性70例,阴性14例,经超声诊断阳性68例,阴性13例。分析诊断效能,产前超声诊断的阳性检出率、灵敏度、特异度、阳性预测值、阴性预测值、诊断符合率、误诊率、漏诊率,与病理学诊断对比无明显差异(P>0.05)。对超声影像学特征进行分析,存在胎盘子宫切口基层菲薄或消失患者占比为85.71%,共计72例;存在胎盘后间隙全失或部分消失患者占比为67.86%,共计57例;存在胎盘内血窦患者占比为65.48%,共计55例;存在胎盘后间隙丰富涡旋样流血信号患者占比为57.14%,共计48例;存在胎盘组织浸润膀胱壁患者占比为14.29%,共计12例。分析临床参数,与年龄<35岁、宫腔操作次数<2次患者相比较,年龄≥35岁、宫腔操作次数≥2次患者前置胎盘并胎盘植入发生率较高,差异显著(P<0.05)。结论:采用产前超声诊断前置胎盘并胎盘植入患者,诊断价值较高,有着明显影像学特征,尤其需要关注高龄、宫腔操作次数较多患者。

Objective:To analyze the value of prenatal ultrasound for diagnosing patients with placenta praevia and placenta implantation.Methods:84 patients with placenta praevia and placenta implantation who attended the Obstetrics Department of Nanjing Gaochun People’s Hospital from November 2021 to February 2023 were selected for this trial,and all of them underwent prenatal ultrasonography,which was used to compare with pathological diagnosis,and to analyze the diagnostic results,diagnostic efficacy,ultrasonographic features,and clinical parameters of the patients.Results:To analyze the diagnostic results,70 cases were diagnosed positively and 14 cases were diagnosed negatively by pathology,and 68 cases were diagnosed positively and 13 cases were diagnosed negatively by ultrasound.Analyzing the diagnostic efficacy,the positive detection rate,sensitivity,specificity,positive predictive value,negative predictive value,diagnostic compliance rate,misdiagnosis rate,and omission rate of prenatal ultrasound diagnosis did not show significant differences when compared with pathological diagnosis(P>0.05).Analyzing the ultrasonic imaging characteristics,the proportion of patients with thin or disappeared basal layer of placental uterine incision was 85.71%,totaling 72 cases;The proportion of patients with total or partial disappearance of the posterior placental hiatus was 67.86%,totaling 57 cases;The proportion of patients with intra-placental hemorrhagic sinus was 65.48%,totaling 55 cases;The proportion of patients with abundant swirling bleeding signals of the posterior placental hiatus was 57.14%in a total of 48 cases;The presence of placental tissue infiltrating the bladder wall in 14.29%of patients,a total of 12 cases.Analyzing the clinical parameters,the incidence of placenta previa with placenta implantation was higher in patients aged≥35 years and with≥2 uterine operations compared with patients aged<35 years and with<2 uterine operations,and the difference was significant(P<0.05).Conclusion:The use of prenatal ultrasound to diagnose patients with placenta previa and placenta implantation has high diagnostic value and has obvious imaging characteristics,especially need to pay attention to patients with advanced age and high number of uterine operations.