超声在妊娠晚期产科出血诊断中的应用分析

目的 探讨超声检查在妊娠晚期产科性出血患者中的诊断价值,并进一步分析对不同类型病因出血的应用效果。方法 选取2017年1月至2019年3月妊娠晚期产科性出血患者182例。收集超声诊断资料和分娩后病理证实情况,以后者为金标准,记录其灵敏度、特异度、约登指数等。结果 超声对妊娠晚期产科性出血的诊断灵敏度为99.4%,特异度为66.7%,约登指数为0.661,95%CI为(0.588,0.734),阳性预测值为98.9%,阴性预测值为80.0%。其中有1例漏诊,2例误诊。不同类型出血的病因诊断符合率有所不同,漏诊发生在胎盘植入病例,误诊发生在胎盘植入和胎盘早剥病例。结论 超声检测在妊娠晚期产科性出血中诊断价值较高,可明确出血原因,且对不同类型出血原因诊断价值不同,值得推广。

Application of ultrasound in diagnosis of obstetrichemorrhage in late pregnancy

Objective To investigate the diagnostic values of ultrasonography in patients with obstetric hemorrhage in late pregnancy and to further analyze the application effect of different types of bleeding.Methods From January 2017 to March 2019,182 cases of obstetric hemorrhage in late pregnancy were prospectively included in the clinical diagnosis.Ultrasound diagnostic data and pathological confirmation after delivery were collected.The latter is the gold standard,and its passing sensitivity,specificity and Yoden index are recorded.Results The diagnostic sensitivity,specificity,Youden index,positive predictive value and negative predictive value of ultrasound for obstetric hemorrhage in late pregnancy were 99.4%,66.7%,0.661,95% CI(0.588,0.734),98.9% and 80.0%,respectively.Among them,1 case was missed and 2 cases were misdiagnosed.The coincidence rate of etiological diagnosis of different types of bleeding is different.Misdiagnosis occurs in placenta implantation cases,and misdiagnosis occurs in placenta implantation and placental abruption cases.Conclusion Ultrasound detection is of high diagnostic value in obstetric hemorrhage in late pregnancy.It can identify the causes of hemorrhage,and has different diagnostic value for different types of hemorrhage,which is worth popularizing.