脐带血管前置的早期超声诊断价值及临床意义

目的探讨超声对胎儿脐带血管前置的早期诊断价值及临床意义。方法回顾分析18例中孕期胎儿脐带血管前置的二维及彩色多普勒超声声像图特点,并随访其预后。结果 18例血管前置患者在中孕期产前超声系统筛查中正确诊断17例,误诊1例（误诊为脐带先露）,准确率为94.44%（其中帆状胎盘14例,副胎盘3例,边缘性脐带入口1例）。典型的超声声像图特征：宫颈内口上方见条管状血管回声,沿宫颈内口或接近宫颈内口处的胎膜穿行,CDFI检查条管状回声内可见血流充填,频谱多普勒检查为脐动脉频谱。行剖宫产18例,18例均存活。结论中孕期产前超声筛查能直观显示血管前置的走形情况及与宫颈内口的关系,提高了血管前置的产前超声检出率,降低了围产儿死亡率。

The Early Diagnosis Value and Clinical Significance of Ultrasonography in Fetal Umbilical Vasa Praevia

Objective To investigate the early diagnosis value and clinical significance of ultrasonography for fetal umbilical vasa praevia. Methods The two-dimnensional doppler color sonographic features of 18 vasa previas were retrospectively analyzed in the period of pre-pregnancy. We also followed the prognosis of 18 cases of vasa previas. Results There were 18 cases of vasa previas, including 17 cases were correctly diagnosed by ultrasound and 1 case were misdiagnosed, the accuracy was 94. 44% （including 14 cases of velamentous insertion of umbilical cord, 3 cases of accessory placenta, I cases of marginal umbilical cord）. The vasa previas has typical ultrasonographic image features： a tubular vessel above the mouth of cervix with ultrasound,which walked through membranes along or near tile cervix at the mouth of the cervix; blood filling was visualized with CI）F1 in Ihe tubular vessel; the umbilical artery spectrum was examined with spectral Doppler ultrasound tech. 18 cases were conducted cesarean birth, the all cases were survived. Conclusion Ultrasonography can visualize the traveling of vasa previa and determine the orientation relationship between the vessels and port cervix. It also ean improve the deteetive rale of vasa previas and rednce prenatal mortality in the period of pre-pregnancy.