胎盘植入的危险因素与超声预警指标的回顾性研究

目的探索胎盘植入发生的危险因素及超声预警指标。 方法连续选取2014年1月至2017年6月在云南省第二人民医院分娩临床及超声诊断胎盘植入46例产妇的临床资料，另选取同期正常分娩无胎盘植入80例产妇（对照组）的临床资料，采用Logistic回归分析等方法分析胎盘植入的危险因素，比较胎盘植入组与对照组产妇各超声异常指标的发生率。 结果胎盘植入组46例产妇前置胎盘、正常子宫胎盘界面消失、子宫肌层极度变薄、胎盘陷窝、胎盘床血管增多的发生率均较对照组明显增加（P<0.05），是胎盘植入的高危超声表现；年龄、产次、剖宫产史、流产次数是胎盘植入的高危因素（P<0.05）。 结论针对有胎盘植入高危因素的孕妇，产科医师和超声医师应提高警惕，尤其发现上述高危超声表现时，胎盘植入的可能性明显增加。

Retrospective study on the risk factors and ultrasonic early warning indicators of placental implantation

ObjectiveTo explore the risk factors and ultrasonic warning indicators of placental accreta. MethodsForty-six continuous cases with placental accreta and 80 normal parturients without placenta accreta were included in the study between January 2014 and June 2017 in the No. 2 People′s Hospital of Yunnan Province. The risk factors such as nationality, occupation, educational level, income, parity, the history of cesarean section, age, and number of abortion were analyzed using logistic regression analysis, and the incidences of various ultrasonic indicators were compared between the case group and control. ResultsAge, parity, history of cesarean section and number of abortion were high risk factors for placental accreta (P<0.05). In the case group, the incidence of placenta previa, disappearance of normal placenta interface, extreme thinning of the uterine muscle layer, fossa invagination, and placental bed increased significantly compared with those of the control group (P< 0.05). ConclusionFor pregnant women with high risk factors of placental accreta, obstetricians and sonographers should be on alert the possibility of placental implantation, especially when such high risk ultrasound findings are found.