產(chǎn)科中妊娠晚期超聲診斷帆狀胎盤的應(yīng)用探討

潘莉

【摘要】 目的 探討產(chǎn)科中妊娠晚期超聲診斷帆狀胎盤的應(yīng)用價值。方法 60例帆狀胎盤患者作為帆狀胎盤組， 根據(jù)患者入院時孕周不同分為中晚期組（孕周25～28周）和晚期組（孕周>28周）， 每組30例;選擇60例健康分娩未診斷帆狀胎盤的產(chǎn)婦作為對照組。比較帆狀胎盤組與對照組產(chǎn)婦分娩結(jié)局;中晚期組和晚期組患者入院時超聲診斷準確率。結(jié)果 帆狀胎盤組多胎、早產(chǎn)、宮內(nèi)死胎、前置胎盤、圍生兒死亡、單臍動脈發(fā)生率分別為20.0%、21.7%、8.3%、20.0%、18.3%、6.7%， 高于對照組的1.7%、

0、0、1.7%、3.3%、0， 差異具有統(tǒng)計學(xué)意義（P<0.05）。晚期組入院時超聲診斷帆狀胎盤準確率為100.0%，

高于中晚期組的80.0%， 差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 帆狀胎盤會增加產(chǎn)婦多胎、早產(chǎn)、宮內(nèi)死胎、前置胎盤、圍生兒死亡等不良妊娠結(jié)局的發(fā)生， 妊娠晚期超聲診斷帆狀胎盤準確率高， 值得在臨床中推廣。

【關(guān)鍵詞】 產(chǎn)科;妊娠晚期;超聲;帆狀胎盤

DOI：10.14163/j.cnki.11-5547/r.2020.02.011

Discussion on ultrasonography in the diagnosis of velamentous placenta in late pregnancy in the obstetrics? ?PAN Li. Department of Ultrasonography， Liwan District Chinese Medicine Hospital， Guangzhou 510145， China

【Abstract】 Objective? ?To discuss the application value of ultrasonography in the diagnosis of velamentous placenta in late pregnancy in the obstetrics. Methods? ?A total of 60 velamentous placenta was taken as velamentous placenta group， and they were divided into middle and late pregnancy group （25-28 weeks of gestation） and the late pregnancy group （> 28 weeks of gestatio）， according to the different gestational weeks of the patients at admission， with 30 cases in each group. 60 healthy parturients without diagnosis of velamentous placenta were selected as the control group. The delivery outcome of velamentous placenta group and control group was compared. Diagnostic accuracy of ultrasound at admission was compared between middle and late pregnancy group and late pregnancy group. Results? ?The incidence of polyembryony， premature delivery， intrauterine fetal death， placenta previa， perinatal deaths， single umbilical artery were 20.0%， 21.7%， 8.3%， 20.0%， 18.3% and 6.7% in velamentous placenta group， which was higher than 1.7%， 0， 0， 1.7%， 3.3% and 0 in the control group， and their difference was statistically significant （P<0.05）. The diagnostic accuracy of ultrasound at admission was 100.0% in late pregnancy group， which was higher than 80.0% in middle and late pregnancy group， and the difference was statistically significant （P<0.05）. Conclusion? ?Velamentous placenta will increase the occurrence of adverse delivery outcome of polyembryony， premature delivery， intrauterine fetal death， placenta previa， perinatal deaths， and ultrasonography in late pregnancy shows high diagnostic accuracy for velamentous placenta. It is worthy of clinical promotion.

【Key words】 Obstetrics; Late pregnancy; Ultrasonography; Velamentous placenta

臍帶蒂部附著在胎膜上， 臍血管經(jīng)過羊膜與絨毛膜之間進入胎盤稱為帆狀胎盤。WHO進行大規(guī)模流行病學(xué)調(diào)查顯示帆狀胎盤發(fā)生率為0.64%～2.14%。帆狀胎盤會造成眾多不良妊娠結(jié)局， 如早產(chǎn)、先天畸形、新生兒死亡等[1]。還有相關(guān)研究指出帆狀胎盤是影響圍生兒預(yù)后的高危因素， 因此產(chǎn)前準確診斷并適時行剖宮產(chǎn)是改善分娩結(jié)局的重要條件[2]。超聲作為一種無創(chuàng)檢查手段， 對診斷各種婦科疾病有較好的價值[3]。目前有關(guān)超聲診斷帆狀胎盤的研究報道較少， 本文擬分析超聲診斷的價值。現(xiàn)報告如下。

1 資料與方法

1. 1 一般資料 收集本院2016年5月17日～2017年5月

17日術(shù)后病理確診為帆狀胎盤的60例患者作為帆狀胎盤組， 根據(jù)患者入院時孕周不同分為中晚期組（孕周25～28周）

和晚期組（孕周>28周）， 每組30例。同時選擇本院健康分娩未診斷帆狀胎盤的60例產(chǎn)婦作為對照組。中晚期……