经腹部超声联合经阴道超声诊断血管前置的临床价值

目的探讨经腹部超声联合经阴道超声在产前诊断血管前置中的临床价值。 方法回顾性分析2018年1月至2019年12月在首都医科大学附属北京妇产医院因临床疑诊血管前置而行剖宫产手术的病例54例。以术后胎盘检查结果为"金标准",对产前经腹部超声联合经阴道超声的检查结果进行分析,应用四格表计算得出其诊断血管前置的敏感度、特异度、阳性预测值、阴性预测值和准确性。 结果54例患者中,经腹部超声联合经阴道超声诊断血管前置47例,其中误诊3例,漏诊2例;5例因临床出血疑似诊断而手术,联合超声及术后证实均无血管前置。经腹部超声联合经阴道超声诊断血管前置的敏感度、特异度、阳性预测值、阴性预测值和准确性分别为95.7%（44/46）、62.5%（5/8）、93.6%（44/47）、71.4%（5/7）和90.1%（49/54）。 结论经腹部超声联合经阴道超声可为产前诊断血管前置提供更多的诊断信息和依据,减少干扰因素,具有良好的诊断效能,值得临床推广应用。

Clinical value of transabdominal ultrasound combined with transvaginal ultrasound in diagnosis of vasa previa

ObjectiveTo explore the clinical value of transabdominal ultrasound combined with transvaginal ultrasound in prenatal diagnosis of vasa previa. MethodsFifty-four women who underwent cesarean section due to suspected vasa previa at Beijing Obstetrics and Gynecology Hospital from January 2018 to December 2019 were analyzed retrospectively. Taking the placenta examination results after operation as the gold standard, the results of prenatal transabdominal ultrasound combined with transvaginal ultrasound were analyzed, and its sensitivity, specificity, and accuracy were calculated. ResultsAmong the 54 patients, 47 were diagnosed with vasa previa by transabdominal ultrasound combined with transvaginal ultrasonography, including three cases of misdiagnosis and two cases of missed diagnosis, 5 were operated because of suspected clinical bleeding, in whom both ultrasound and postoperative examination revealed no vasa previa. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of transabdominal ultrasound combined with transvaginal ultrasound in the diagnosis of vasa previa were 95.7% (44/46), 62.5% (5/8), 93.6% (44/47), 71.4% (5/7), and 90.1% (49/54), respectively. ConclusionIn prenatal diagnosis of vasa previa, the combined application of transabdominal ultrasound and transvaginal ultrasound can provide more diagnostic information, reduce interference, and make the diagnosis more accurate, which is worthy of clinical promotion.