胎盘植入的产前超声诊断及临床应用

目的 探讨产前应用超声诊断胎盘植入的临床价值。方法 选择2011年3月到2013年3月北京市通州区妇幼保健院进行产前超声检查，产后经临床确诊为胎盘植入的40例产后患者为研究对象，分别将患者产前、产后出血情况，胎盘位置是否合并出血等进行分组比较，观察并记录超声诊断结果 及临床预后。结果 本组产妇胎盘增厚2例，胎盘内血窦形成3例，胎盘与子宫肌层分界不清5例，超声显示胎盘近子宫肌层处血流丰富2例。前壁胎盘组与合并中央型前置胎盘组的患者，检出率明显高于非前壁胎盘组与非合并中央型前置胎盘组。合并产前出血的患者产后出血发生率明显高于非合并产前出血患者，差异具有统计学意义（P〈0．05）。结论 胎盘植入因缺乏典型的临床表现及检测指标，漏诊率很高。而运用产前超声结合患者产后出血情况及胎盘位置类型可有效提示临床预后。

Prenatal ultrasound diagnosis of placenta accreta and clinical application

Objective To investigate the clinical value of prenatal ultrasound diagnosis of placenta accreta. Methods March 2011 to March 2013 Tongzhou District MCH hospital of Beijing, the clinical diagnosis of postpartum placenta accreta 40 cases of postpartum patients for the study, prenatal, postpartum hemorrhage , placental location, such as whether the hemorrhage group, to observe and record the results of ultrasound diagnosis and prognosis. Results The maternal placental thickening two cases, the formation of three cases of placenta sinusoid, the placenta and the uterine myometrium unclear boundaries five cases, ultrasound showed placental blood flow near the myometrium at rich two cases. Group of patients with combined anterior placenta previa central group, the detection rate was significantly higher than that of the non - anterior placenta group and the non - consolidated central placenta previa group. Patients with antenatal hemorrhage incidence of postpartum hemorrhage was significantly higher than that of the non - consolidated antepartum hemorrhage patients, there was a statistically significant difference （ P 〈 0. 05 ）. Conclusion Placenta implants due to lack of typical clinical manifestations and detection index, has a high rate of misdiagnosis. The combined use of prenatal ultrasound in patients with postpartum hemmThage and placental location type can effectively prompt clinical outcomes.