胎盘植入产前超声诊断的临床应用价值

目的：探讨产前超声诊断在胎盘植入的临床应用价值。方法回顾性分析34例经由临床及病理学证实为胎盘植入的孕妇相关资料，分析其多普勒超声检查的声像学特征，及胎盘植入与产后出血及胎盘的关系。结果经由产前超声诊断提示共11例确诊，占比32.4％，出现漏诊23例，占比67.6％；经产前超声诊断提示胎盘植入的11例患者的影像学特征主要有：胎盘后间隙部分或者全部消失，胎盘有内漩涡流形成，胎盘附着处的子宫肌层菲薄及胎盘异常性增厚等，产后大出血与非产后大出血的胎盘植入发生率为（56.3％vs11.1％），胎盘前置与非胎盘前置的胎盘植入发生率为（71.4％vs 5.0％），前壁胎盘与非前壁胎盘的发生率为（53.3％vs15.8％），P＜0.05。结论经超声检查对胎盘植入进行产前的诊断，对预防产后出血、保障母婴平安有着重要的价值。

Clinical Value of Prenatal Ultrasound Diagnosis of Placenta Implantation

Objective To explore the clinical value of prenatal ultrasound diagnosis of placenta implantation .Methods Doing retrospective analysis of 34 cases with placenta implantation confirmed by clinical and pathological pregnant relevant information, analyzing features of Doppler ultrasonographic and relationship of postpartum hemorrhage with placenta implantation placenta .Results Among 34 cases, 11 cases were diagnosed as placenta implantation by prenatal ultrasound , accounting for 32.4%.23 cases were missed , accounting for 66.7%.The main imaging characteristics were as follows：some or all of clearance of behind placenta disappeared , there was vortex flow in the placenta formation ,and there was myometrium meager attachment of the placenta and placental abnormalities thickening in the 11 placenta implantation of 34 cases patients diagnosed by prenatal ultrasound.Incidence of placenta accreta in postpartum hemorrhage patients and non-postpartum hemorrhage patients was 56.3%vs11.1%,incidence of placenta accreta in placenta previa patients and non -Placenta previa patients was 71.4%vs 5.0%, and incidence of placenta accreta in anterior placenta and non -anterior placenta was 53.3%vs15.8%,P〈0.05.Conclusion Prenatal ultrasound diagnosis of placenta implantation could prevention of postpartum hemorrhage ,and it has an important value to keep mothers′and babies′safety.