经阴道超声检测黄体及子宫螺旋动脉血流用于诊断早孕流产的临床价值

  目的  评价经阴道超声诊断早孕流产的临床效果。  方法  选择140例先兆流产患者和140例健康孕妇为研究对象，均进行经阴道超声检测，跟踪妊娠结局，比较不同妊娠结局孕妇黄体性状和超声回声特征，统计黄体和子宫螺旋动脉血流超声指标数值差异。  结果  健康孕妇黄体形状均为圆环状(100.00%)，先兆流产保胎成功组少部分黄体呈现棒状(21.21%)和点状(4.04%)，而早孕流产组中黄体呈现棒状(34.15%)和点状的比例(26.83%)最高；健康孕妇黄体不均质低回声检出率最低(12.86%)，先兆流产保胎成功组居中(38.38%)，而早孕流产组最高(58.54%)。健康孕妇黄体血流收缩期峰值流速(PSV)显著高于其他2组，而阻力指数(RI)显著低于其他2组(均P＜0.05)，且先兆流产保胎成功组黄体血流PSV显著高于早孕流产组，而黄体血流RI显著低于早孕流产组(均P＜0.05)。健康孕妇子宫螺旋动脉血流搏动指数(PI)、RI和S/D均显著低于其他2组(均P＜0.05)，且先兆流产保胎成功组子宫螺旋动脉血流PI和RI均显著低于早孕流产组(均P＜0.05)。  结论  经阴道超声检测黄体及子宫螺旋动脉血流对早孕流产的诊断及预后评估具有较高的诊断价值。 

Clinical value of transvaginal ultrasonography in the diagnosis of abortion during early pregnancy

  Objective  To evaluate the clinical effect of transvaginal ultrasound in the diagnosis of abortion during early pregnancy.  Methods  The research objects were 140 cases of threatened abortion and 140 cases of healthy pregnant women. The pregnancy outcomes were tracked by using transvaginal ultrasound. The luteal characters and ultrasonic echo characteristics of pregnant women with different pregnancy outcomes were compared, and the differences of ultrasound indexes of corpus luteum and uterine spiral artery blood flow were counted.  Results  The shape of corpus luteum in healthy pregnant women was circular (100.00%); in threatened abortion group, a small number of corpus luteum showed rod shape (21.21%) and dot shape (4.04%). In the abortion of early pregnancy group, the proportion of the subjects with rod shape (34.15%) and dot shape (26.83%) corpus luteum was the highest. The detection rate of heterogeneous hypoechoic corpus luteum in healthy pregnant women was the lowest (12.86%), and in the middle in the group with successful fetus protection group among those with threatened abortion was (38.38%), and the highest in the abortion of early pregnancy group (58.54%). The PSV of luteal blood flow of healthy pregnant women was significantly higher than that of the other two groups, whereas RI was significantly lower than that of the other two groups (all P < 0.05). The PSV(peak systolic velocity) of luteal blood flow in the fetus protection group among those with threatened abortion group was significantly higher than that in the abortion of early pregnancy group, whereas the luteal blood flow RI was significantly lower than that in the abortion of early pregnancy group (all P < 0.05). The pulsatility index (PI), resistive index(RI) systolic/diastolic (S/D) ratio in healthy pregnant women were significantly lower than those in the other two groups (all P < 0.05), and the PI and RI of uterine spiral artery blood flow in the successful fetus protection group among those with threatened abortion were significantly lower than those in the abortion of early pregnancy group (all P < 0.05).  Conclusion  Transvaginal ultrasound detection of corpus luteum and uterine spiral artery blood flow has a high value in the diagnosis and prognosis evaluation of abortion of early pregnancy.