胎盘早剥的声像图表现及妊娠结局分析

目的 探讨胎盘早剥声像图特征及妊娠结局。方法 收集132例经产后诊断为胎盘早剥孕妇的产前超声检查资料，分析其声像图表现及妊娠并发症。结果 超声检出胎盘早剥48例，检出率36.36%（48/132），漏诊率63.64%（84/132）。胎盘早剥声像图表现为胎盘增厚29例、胎盘实质回声异常16例、胎盘后方回声异常9例、胎盘边缘回声异常6例、胎盘胎儿面回声异常4例、宫壁与胎膜间回声异常2例以及羊水池内回声异常7例；主要并发症为剖宫产、子宫胎盘卒中、弥漫性血管内凝血、产后出血、早产、新生儿重度窒息及围生儿死亡，经超声检出胎盘早剥者以上并发症发生率均高于超声未检出者（P均<0.05）。结论 胎盘早剥产前超声检出率低；超声检出胎盘早剥者妊娠结局较差。

Ultrasonographic features and pregnancy outcomes of placental abruption

Objective To investigate the ultrasonic features of placental abruption (PA) and its outcomes of pregnancy. Methods Prenatal ultrasonic data of 132 pregnant women diagnosed as PA after delivery were collected, and the ultrasonic findings and pregnancy complications were analyzed. Results PA was detected with ultrasonography in 48 patients while misses in 84 patients, the detection rate was 36.36% (48/132), and the missed diagnosis rate was 63.64% (84/132). Ultrasound showed placental thickening in 29 cases, intraplacental abnormal echo in 16, retroplacental abnormal echo in 9, placental marginal abnormal echo in 6, abnormal echo at placental fetal surface in 4, abnormal echo between uterine wall and amniotic membrane in 2, abnormal echo in amniotic cavity in 7 cases. The main complications of PA included cesarean section, uterine placental stroke, disseminated intravascular coagulation, postpartum hemorrhage, premature birth, severe neonatal asphyxia and even perinatal death. The incidences of complications in pregnant women with PA detected with ultrasound were higher than those in pregnant women with PA missed with ultrasound (all P<0.05). Conclusion Prenatal ultrasonic detection rate of PA is low, and the pregnancy outcomes of pregnant women with PA detected with ultrasound is relatively poor.