产前超声在前置胎盘并胎盘植入诊断中的应用价值

罗晓+阳成英+郑映开

[摘要]目的 探讨产前超声在前置胎盘并胎盘植入诊断中的应用价值。方法 选取我院2016年3～12月门诊产检时疑似胎盘植入的60例患者，均于产前实施彩色多普勒超声诊断，分析患者的影像学特征，判断是否合并胎盘植入，并以病理检查结果为依据，计算超声诊断的准确率。结果 本研究60例对象中，彩色多普勒超声前置胎盘并胎盘植入的检出率为13.33%，手术病理诊断检出率为15.00%，两种检测方法比较，差异无统计学意义（P>0.05）。超声的总检出准确率为88.89%。结论 产前超声诊断具有操作简单、可重复性、准确率高等显著特征，是前置胎盘并胎盘植入的有效诊断方法，具有极大的推广应用价值。

[关键词]前置胎盘；胎盘植入；产前；超声诊断

[中图分类号] R714.46+2 [文献标识码] A [文章编号] 1674-4721（2017）06（c）-0060-03

[Abstract]Objective To explore the application value of prenatal ultrasound in the diagnosis of placenta previa and implantation.Methods 60 patients with suspected placenta accreta were selected during antenatel examinations in our hospital from March to December in 2016，all of them were performed with antenatal color Doppler ultrasonography.The imaging features of the patients were analyzed for judgment of placenta accrete or not.Based on the results of pathological examination，the accuracy of ultrasound diagnosis was calculated.Results Among these participants，the detection rate of placenta previa and implantation was 13.33% by color Doppler ultrasonography，and the detection rate by surgical pathology was 15.00%，there was no significant difference （P>0.05）.The accuracy rate of color Doppler ultrasonography was 88.89%.Conclusion Prenatal ultrasound diagnosis is characterized by simple operation，reproducibility，and high accuracy，and is an effective way to diagnose the placenta previa and implantation，which is of great extensive application value.

[Key words]Placenta previa；Placenta accreta；Prenatal；Ultrasound diagnosis

由于多种因素的交互作用，导致前置胎盘具有较高的发病率，严重影响患者健康。该类患者的胎盘附着于子宫下段或者胎盘下缘甚至覆盖其宫颈内口位置，具体位置低于胎儿的先露部[1]。该病是导致妊娠晚期出血的主要原因，也属于妊娠期严重并发症之一。临床实践中，按照胎盘植入患者子宫肌层的具体深度以及是否侵入子宫毗邻器官等，具体划分为胎盘粘连、胎盘植入、穿透性胎盘植入；按照不同的植入面积，则又可以划分为完全性以及部分性胎盘植入[2]。胎盘植入的并发症主要有临近脏器的损伤、宫腔感染、妊娠中晚期所发生自发性子宫破裂以及因分娩时胎盘不能够完整剥离所导致的失血性休克、腹腔内出血等。前……