超声评分法预测凶险性前置胎盘合并胎盘植入及不良妊娠结局

目的:分析超声评分法在凶险性前置胎盘合并胎盘植入及不良妊娠结局中的预测方法及价值。方法:将100例凶险性前置胎盘疑似胎盘植入患者纳入本研究，利用超声评分法对患者的胎盘植入程度进行评估，将评估结果与术后病理结果进行对比分析。结果:超声评分法在粘连型、植入型和穿透型患者中的检出率分别为100.00%、100.00%和86.36%，在凶险性前置胎盘合并胎盘植入的总检出率为95.59%，与病理诊断相比并无显著差异（P>0.05）；超声评分法在植入型中的灵敏度和特异度分别为100.00%和72.22%，在穿透型中的灵敏度和特异度分别为86.36%和100.00%；植入型和穿透型患者的不良妊娠结局发生率分别为76.09%和100.00%，均显著高于粘连型（P<0.05），且穿透型明显高于植入型（P<0.05）。结论:超声评分法可以有效实现对凶险性前置胎盘合并胎盘植入患者的预测，通过对患者病理类型分类，发现穿透型患者的不良妊娠结局发生率最高，应当在临床中采取预防性干预措施。

Ultrasound scoring for prediction of dangerous placenta previa combined with placenta accretaand analysis of adverse pregnancy outcomes

Objective To analyze the method and value of ultrasound scoring in assessing dangerous placenta previa combinedwith placenta accreta and predicting adverse pregnancy outcomes. Methods A total of 100 patients with dangerous placentaprevia and suspected placenta accreta were enrolled in this study. The degree of placenta accreta was evaluated usingultrasound scoring, and the evaluation results were then compared with postoperative pathologic results. Results Thedetection rates of adhesion type, accreta type and penetrating type by ultrasound scoring were 100.00%, 100.00% and86.36%, respectively, and the total detection rate of dangerous placenta previa combined with placenta accreta was 95.59%.Compared with pathologic diagnoses, there was no significant difference (P>0.05). The sensitivity and specificity ofultrasound scoring in accreta type were 100.00% and 72.22%, and those in penetrating type were 86.36% and 100.00%. Theincidences of adverse pregnancy outcomes in accreta type and penetrating type was higher than that of adhesion type(P<0.05), and the incidence of adverse pregnancy outcomes in penetrating type was significantly higher than that of accretatype (100.00% vs 76.09%, P<0.05). Conclusion Ultrasound scoring can effectively predict dangerous placenta previacombined with placenta accreta. By classifying the pathologic types, it is found that the incidence of adverse pregnancyoutcomes in penetrating type is the highest, and some preventive measures should be taken in clinical interventions.