凶险型前置胎盘合并胎盘植入的产前超声诊断分析

发布时间：2018-03-02 02:28

本文关键词： 超声检查产前前置胎盘胎盘侵入性　出处：《中华医学超声杂志(电子版)》2016年03期 　论文类型：期刊论文

【摘要】：目的总结凶险型前置胎盘(PPP)合并胎盘植入产前超声声像图特征,分析PPP合并胎盘植入产前超声漏误诊原因。方法应用经腹部联合经会阴部彩色多普勒超声对临床拟诊为PPP的51例孕妇行系统超声检查,与产后手术病理及临床随访结果对照分析。结果 51例PPP患者产前超声诊断完全性前置胎盘39例,不完全性前置胎盘12例,其中合并胎盘植入40例(78.4%,40/51),未合并胎盘植入7例(13.7%,7/51)。产后临床及手术病理检查证实51例PPP患者合并胎盘植入42例(82.4%,42/51),未合并胎盘植入9例(17.6%,9/51);因超声图像不典型产前超声漏诊2例(3.9%,2/51),误诊2例(3.9%,2/51,将膀胱静脉曲张误认为血管横跨胎盘与膀胱间)。51例PPP患者经腹部超声检查显示胎盘增厚、弥漫性或局灶性胎盘实质内腔隙血流25例,胎盘后间隙消失、胎盘附着处子宫肌层变薄(≤2 mm)44例,子宫肌层弓状动脉排列紊乱34例,胎盘附着处子宫浆膜层-膀胱交界处血管丰富紊乱18例;经会阴部超声显示子宫下段膨隆、胎盘增厚25例,宫颈膨大、胎盘局部向宫颈内伸入6例,子宫下段及宫颈管胎盘覆盖处血流丰富8例。结论孕妇凶险型前置胎盘有特征性超声表现,经腹部联合经会阴超声检查有助于正确诊断而减少误漏诊。
[Abstract]:Objective to summarize the placenta previa (PPP) complicated with placenta accreta antenatal sonographic features, analysis of PPP complicated with placenta accreta antenatal ultrasound misdiagnosis. Methods abdominal joint perineal color Doppler ultrasound diagnosed 51 cases of pregnant women for PPP ultrasound, and clinical follow-up results were analyzed after operation the pathological results of 51 cases of PPP patients. The prenatal ultrasound diagnosis of complete placenta previa in 39 cases, 12 cases of incomplete placenta previa, 40 cases with placenta implantation (78.4%, 40/51), with 7 cases of placenta accreta (13.7%, 7/51). After clinical and pathological examination confirmed 51 cases of 42 PPP patients with placenta implant (82.4%, 42/51), with 9 cases of placenta accreta (17.6%, 9/51); because of atypical ultrasonic images of prenatal ultrasound misdiagnosis of 2 cases (3.9%, 2/51), 2 cases were misdiagnosed (3.9%, 2/51, bladder varices mistaken across the placenta and vascular bladder Cystine) between placenta thickening by abdominal ultrasound examination showed that.51 patients with PPP, diffuse or focal placental parenchyma cavity gap in 25 patients, disappeared after placental clearance, placenta myometrial thinning (less than 2 mm) in 44 cases, uterine arcuate artery disorder in 34 cases, at the uterine serosa bladder junction vascular disorders and 18 cases of placenta attached; perineal ultrasound showed lower uterine segment swelling, 25 cases of cervical enlargement, placenta thickening, placenta to cervical extend in 6 cases, lower uterine segment and cervical placenta covered rich blood flow in 8 cases. Conclusion: pregnant women with placenta previa features ultrasound, abdominal sonography is helpful to the correct diagnosis and reduce misdiagnosis.

【作者单位】：南京医科大学附属苏州医院
【分类号】：R445.1;R714.56

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