妊娠中期超声对持续性前置胎盘预测价值的研究

发布时间：2018-10-04 20:18

【摘要】：目的探讨前置胎盘妊娠妇女妊娠中期的超声影像学表现对持续性前置胎盘(PPP)的预测价值。方法选择妊娠早、中期超声检查显示胎盘处于低置和/或前置状态的200例单胎孕妇,按产检孕周分为11~13+6周、14~17+6周、18~23+6周、24~27+6周4个阶段进行检查,观察胎盘附着位置,测量胎盘下缘距宫颈内口的距离,在孕晚期经超声检查确定胎盘状态。结果受检孕妇中有28例在孕晚期超声诊断为前置胎盘,结果均通过剖宫产术后或分娩后证实。对28例前置胎盘研究发现,不同孕周胎盘下缘距宫颈内口距离可初步预测PPP的可能性:在11~13+6周,胎盘下缘距宫颈内口距离≥21.8 mm时,PPP敏感性为77.810%,特异性为80.402%;在14~17+6周,胎盘下缘距宫颈内口距离≥18.2 mm时,PPP敏感性为82.322%,特异性为83.318%;在18~23+6周,胎盘下缘距宫颈内口距离≥14.5 mm时,PPP敏感性为87.531%,特异性为85.715%;在24~27+6周,胎盘下缘距宫颈内口距离≥11.2 mm时,PPP敏感性为96.407%,特异性为83.342%。结论在前置胎盘中,不同孕周胎盘下缘与宫颈内口间的距离能用于预测PPP的可能性,对临床指导及判断预后具有重要的价值。
[Abstract]:Objective to evaluate the predictive value of ultrasound imaging findings of placenta previa in the second trimester of pregnancy for persistent placenta previa (PPP). Methods 200 cases of single pregnancy with placenta in low and / or anterior placenta were selected for early and middle pregnancy. According to the gestational weeks, they were divided into 4 stages: 1113 6 weeks, 1417 6 weeks, 1823 weeks and 2427 weeks, and the placenta attachment position was observed. To measure the distance from the lower edge of the placenta to the cervix and to determine the placenta state by ultrasonography in the third trimester of pregnancy. Results 28 cases of pregnant women were diagnosed as placenta previa by ultrasonography in the third trimester of pregnancy. The results were confirmed by cesarean section or after delivery. In the study of 28 cases of placenta previa, it was found that the distance between the lower edge of placenta of different gestational weeks and the inner mouth of cervix could preliminarily predict the possibility of PPP: at 11136 weeks, the sensitivity and specificity of PPP were 77.810 10 and 80.402 when the distance from the lower edge of placenta to the inner mouth of cervix was more than 21.8 mm, and the specificity was 80.402% at 1416 weeks. When the distance from the lower placenta to the cervix was more than 18.2 mm, the sensitivity was 82.322 and the specificity was 83.318.The sensitivity was 87.531 and the specificity was 85.715when the distance from the lower placenta to the cervix was more than 14.5 mm at 18236 weeks, and the specificity was 85.715g at 2427 weeks. When the distance from the lower placenta to the cervix was greater than 11.2 mm, the sensitivity was 96.407and the specificity was 83.342. Conclusion in placenta previa, the distance between the lower margin of placenta and cervical internal orifice in different gestational weeks can be used to predict the possibility of PPP, which is of great value for clinical guidance and prognosis.
【作者单位】：河北医科大学附属哈励逊国际和平医院超声科;
【基金】：哈励逊国际和平医院研究生科研基金(No:2014-09)
【分类号】：R445.1;R714.5

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