彩色多普勒超声诊断帆状胎盘并血管前置的价值

目的探讨彩色多普勒超声对帆状胎盘并血管前置的诊断价值及其临床意义。方法回顾性分析13例帆状胎盘并血管前置的二维及彩色多普勒超声声像图特点,随访胎儿预后。结果产后诊断帆状胎盘并血管前置例13例,超声正确筛查10例,准确率76.9%（10/13）,误诊3例（1例误诊为脐带先露,1例误诊为脐带脱垂,1例误诊为子宫下段扩张的血管）。典型的声像图特征是：彩色多普勒显示脐带根部入口远离胎盘,脐血管在胎膜下延伸进入胎盘实质,血管跨过宫颈内口,血流频谱为脐动脉血流频谱。行剖宫产11例,经阴道分娩2例,活婴12例,死婴1例。结论彩色多普勒超声检查能直接显示脐带根部胎盘入口与胎盘、前置血管与宫颈内口之间的位置关系,是诊断帆状胎盘并血管前置的首选方法,能降低围生儿病死率,有较高的临床价值。

The diagnostic value of color Doppler ultrasound in velamentous placenta associated with vasa previa

Objective To explore the diagnosic and clinical value of color Doppler ultrasound for the velamentous placenta associated with vasa previa.Methods A retrospective analysis was made on the two-dimensional and color Doppler sonographic features of 13 cases of the velamentous placenta associated with vasa previa and then follow-up of fetal outcome.Results There were 13 cases of velamentous placenta associated with vasa previa.In all cases,10 cases were correctly diagnosed by ultrasound and the accuracy was 76.9%(10/13),3 cases were misdiagnosed(1 case exposed before the umbilical cord,1 cord prolapse,an expansion of the lower uterine blood vessels.) The typical sonographic features are: color doppler shows the entrance from the root of the umbilical cord placenta,umbilical cord into the placenta in the fetal membranes in real terms under the extension,and the blood vessels across the mouth of the cervix,umbilical artery flow spectrum for the spectrum.Among 13 cases pregnant women,11 cases were conducted cesarean birth and 2 cases gave birth by natural labor including living babies of 12 cases and stillbirths of 1 case.Conclusion Ultrasonography can directly visualize the root of placental umbilical cord and placenta,and the front entrance of blood vessels and cervical position relationship with the diagnosis of placental blood vessels sail-shaped front of the preferred method,can reduce perinatal mortality in children,with high clinical application.