彩色多普勒超声产前诊断胎盘植入分析
|
摘要
目的:探讨彩色多普勒超声对产前诊断胎盘植入的价值,分析其图像特征及漏诊原因,提高诊断率。方法:选取2014年5月~2014年11月经产前超声检查、临床手术或病理证实胎盘植入的10例患者临床资料进行回顾性分析。结果:10例中,产前超声诊断胎盘植入4例,符合率为40%(4/10)。超声声像图表现胎盘后间隙不清晰4例,胎盘与肌层间异常血流及子宫肌层明显变薄各3例,胎盘内漩涡形成2例。植入部位:前壁共5例,检出3例、漏诊2例;左侧壁1例、检出1例;左侧宫角1例、右侧宫底1例、后壁2例均漏诊。产前确诊胎盘植入晚孕3例、中孕1例。宫腔操作史10例,剖宫产史8例(其中1例为2次),合并前置胎盘6例(其中3例为凶险型),合并低置胎盘1例。结论:彩色多普勒超声对产前诊断胎盘植入具有重要价值。胎盘植入超声声像图具有一定的特异性表现。胎盘植入部位及孕周影响诊断率。宫腔操作史、剖宫产史、合并前置胎盘是胎盘植入的高危因素。
Objective: To explore the value of color doppler ultrasound prenatal diagnosis of placenta increta. To improve the ultrasound diagnostic rate by discussing their sonogram feature and analyzing the causes of misdiagnosis. Methods: The sonogram of 10 patients diagnosed clinically with placenta increta was retrospectively analyzed. Results: Four patients accounting for 40% was diagnosed placenta increta with ultrasonic sonogram for the features as follows: disappeared gap behind placenta( 4 patients),thinner myometrium( 3 patients),multiple irregular vascular spaces within placenta bed( 3 patients) and the forming of placental lacunae( 2 patients). 3 of 5 patients which the placental implantation sites in the anterior uterine wall and 1 patient in the left uterine wall were prenatal diagnosed,while the others in the uterine horns,in the uterine fundus and in the posterior wall were misdiagnosed. 10 patients had a history of uterine cavity operation,8 patients had a history of previous cesarean section,and 6 patients with placenta previa and 1 patient with placenta low- lying. Conclusion: The color doppler ultrasound plays an important role in diagnosing placenta increta. There are some specific display in ultrasonic sonogram. The rate of diagnosis of placenta increta relates to the placental implantation site. The history of uterine cavity operation,previous cesarean section and placenta previa are the risk factors of the placenta increta.
Objective: To explore the value of color doppler ultrasound prenatal diagnosis of placenta increta. To improve the ultrasound diagnostic rate by discussing their sonogram feature and analyzing the causes of misdiagnosis. Methods: The sonogram of 10 patients diagnosed clinically with placenta increta was retrospectively analyzed. Results: Four patients accounting for 40% was diagnosed placenta increta with ultrasonic sonogram for the features as follows: disappeared gap behind placenta( 4 patients),thinner myometrium( 3 patients),multiple irregular vascular spaces within placenta bed( 3 patients) and the forming of placental lacunae( 2 patients). 3 of 5 patients which the placental implantation sites in the anterior uterine wall and 1 patient in the left uterine wall were prenatal diagnosed,while the others in the uterine horns,in the uterine fundus and in the posterior wall were misdiagnosed. 10 patients had a history of uterine cavity operation,8 patients had a history of previous cesarean section,and 6 patients with placenta previa and 1 patient with placenta low- lying. Conclusion: The color doppler ultrasound plays an important role in diagnosing placenta increta. There are some specific display in ultrasonic sonogram. The rate of diagnosis of placenta increta relates to the placental implantation site. The history of uterine cavity operation,previous cesarean section and placenta previa are the risk factors of the placenta increta.
引文
[1]曹泽毅,主编.妇产科学[M].北京:人民卫生出版社,2008:238.
[2]王陶然.胎盘植入相关因素及妊娠结局的分析[J].中国优生与遗传杂志,2013(01):44-45.
[3]李胜利,文华轩.超声医学[M].第6版.北京:人民军医出版社,2014:1263.
[4]彭软,谢红宁,杨建波,等.胎盘植入的产前超声诊断及其影响因素研究[J].中国临床医学影像杂志,2010(01):67-69.
[5]王莉,吴青青,马玉庆,等.超声诊断孕早期胎盘植入[J].中国介入影像与治疗学,2014,11(7):431.
[6]李建英,陈瑞坚,邱建芬,等.三维超声在胎盘粘连、胎盘植入诊断的应用价值[J].中国社区医师(医学专业),2012,14(17):258-259.
[7]钟晓红,谢小健,吴幼平,等.胎盘植入46例超声检查结果分析[J].福建医药杂志,2011,(8):110-111.
[8]翁轶南,来蕾,倪卫星.胎盘植入的产前超声诊断分析[J].中国妇幼保健,2014,(10):1621.
[2]王陶然.胎盘植入相关因素及妊娠结局的分析[J].中国优生与遗传杂志,2013(01):44-45.
[3]李胜利,文华轩.超声医学[M].第6版.北京:人民军医出版社,2014:1263.
[4]彭软,谢红宁,杨建波,等.胎盘植入的产前超声诊断及其影响因素研究[J].中国临床医学影像杂志,2010(01):67-69.
[5]王莉,吴青青,马玉庆,等.超声诊断孕早期胎盘植入[J].中国介入影像与治疗学,2014,11(7):431.
[6]李建英,陈瑞坚,邱建芬,等.三维超声在胎盘粘连、胎盘植入诊断的应用价值[J].中国社区医师(医学专业),2012,14(17):258-259.
[7]钟晓红,谢小健,吴幼平,等.胎盘植入46例超声检查结果分析[J].福建医药杂志,2011,(8):110-111.
[8]翁轶南,来蕾,倪卫星.胎盘植入的产前超声诊断分析[J].中国妇幼保健,2014,(10):1621.