子宫切口部位胎盘植入的产前超声诊断价值分析

目的探讨产前超声检查对子宫切口部位胎盘植入的诊断价值及其临床指导意义。方法结合剖宫产术后结果,回顾性分析21例子宫切口部位胎盘植入的超声图像特点。结果 21例子宫切口部位胎盘植入者产前正确诊断20例,诊断符合率95.2%(20/21);漏诊1例。合并中央型前置胎盘19例,低置胎盘2例。19例子宫切口部位胎盘植入患者为典型声像图表现:1前置胎盘;2子宫前壁下段子宫切口部位胎盘后间隙消失;3胎盘内陷凹;4CDFI示弓形动脉走行呈节段性血流信号中断,呈簇状、团状血流。2例患者声像图表现为非典型。结论产前超声检查能显示子宫切口部位胎盘植入的范围和血流情况,也能显示胎盘位置及其与宫颈内口、子宫切口部位的关系,可为临床手术医师提供重要的术前相关信息。

Prenatal diagnostic value of placenta implantation of uterine incision with prenatal ultrasonography

Objective To explore the diagnosis value and clinical application of placenta implantation of uterine incision with prenatal ultrasonography.Methods Combined with the results after cesarean section,ultrasonographic characteristics in 21 patients with placenta implantation of uterine incision were retrospectively analyzed.Results In 21 patients with placenta implantation of uterine incision,20 patients were accurately diagnosed.The diagnostic accordance rate was 95.2%（20/21）,1 case was misdiagnosed.There were 19 patients combined with central placenta previa and 2 cases with low-lying placenta.Nineteen patients had representative ultrasonographic characteristics：1placenta previa,2the gap between the incision on inferior segment of uteru anterior wall and placenta disappeared,3 excavation in placenta,4 Color Doppler flow imaging showed that the flow signal of arcuate artery was interrupted segmentally,and morphologic characteristics of the flow looked like clustered or round.Two patients had atypical features.Conclusion Prenatal ultrasonography can show the range and the blood of placenta implantation of uterine incision,placenta position and the relationship of placenta position with intracervical mouth and uterine incision,which can provide an important preoperative information for clinical surgery doctor.