产前胎盘超声评分对诊断前置胎盘合并胎盘植入临床研究

目的探讨产前胎盘超声评分对前置胎盘合并胎盘植入的临床价值。方法回顾性分析312例产妇资料,按照产检、剖宫产手术结论及病理结果,将前置胎盘合并胎盘植入者归为植入组(162例),其中粘连型98例,植入型41例,穿透型23例;前置胎盘未合并胎盘植入者归为非植入组(150例)。分析两组患者超声影像学特点来进行评分,评价产前胎盘超声评分对前置胎盘合并胎盘植入的诊断价值及临床应用意义。结果根据产前胎盘超声评分结果,植入组评分高于非植入组且差异具有统计学意义;植入组中三组间比较,差异具有统计学意义。以ROC曲线为标准预测各型胎盘植入超声评分界值:非植入型与粘连型的界值为3分,粘连型与植入型的界值为6分;植入型与穿透型的界值为10分。超声评分与手术结论及病理结果具有高度的一致性。结论产前胎盘超声评分对前置胎盘合并胎盘植入早期诊断具有重要作用,可以进一步提高诊断准确性,值得临床推广。

The Clinical Value of Prenatal Ultrasonic Signs Score in Placenta Previa Complicated With Placenta Accreta

Objective To investigate the clinical value of prenatal ultrasonic signs score in placenta previa with placenta accreta.Methods 312 cases were analyzed retrospectively.According to the results of operation and pathology after cesarean section,the placenta previa combined with placenta implantation was classified as implantation group(162 cases),including adhesive type(98 cases),implants type(41 cases),penetrating type(23 cases),and 150 cases with placenta previa without placenta implantation.The ultrasonographic features of the two groups were evaluated,and the diagnostic value and clinical significance of ultrasound score for placenta previa combined with placenta accreta was evaluated.Results(1)The ultrasound score of the implant group was significantly higher than that of the non implant group,and the difference between the three groups was statistically significant.(2)ROC curve was used to predict the boundary value of each type of placenta accreta:The boundary value of non implants and adhesions was 3,and the boundary value of adhesions and implants was 6 and the boundary value of the implants and percreta types was 10.(3)The ultrasonic signs score shows that it had excellent consistency with surgical and the pathologic findings.Conclusions Prenatal ultrasonic signs score can improve the diagnostic accuracy of placenta previa combined with placenta accreta,it is worthy of clinical promotion.