超声征象评分法诊断凶险性前置胎盘合并胎盘植入的应用
The Value of Prenatal Diagnosis of Ultrasonographic Scoring System in Placenta Previa with Placenta Accrete
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摘要: 目的 总结凶险性前置胎盘 (PPP) 合并胎盘植入时的超声特征, 探讨超声征象评分法用于评估PPP是否合并胎盘植入的临床价值.方法 对昆明医科大学附属延安医院行剖宫产分娩的179例PPP病例的超声特征进行回顾性分析, 以产后结果为金标准, 分为非植入型和植入型.结果 非植入型PPP与植入型PPP的超声评分有统计学差异 (P<0.05) ;将胎盘厚度、胎盘后间隙、胎盘实质旋涡情况、胎盘基底部-子宫交界面血流、子宫浆膜层-膀胱交界面情况、宫颈形态6个指标纳入ROC曲线分析, 非植入型和植入型的超声评分最佳分界点为6分.结论 超声征象评分法用来评估凶险性前置胎盘是否合并胎盘植入具有较高特异性和敏感度, 是可靠的辅助检查方法, 具有良好的应用前景.Abstract: Objective To summarize the characteristics of PPP disease complex with placenta implication and explore the value of prenatal ultrasonographic scoring system in placenta prevlia complicate with placenta accrete.Me thods An retrospective analysis was conducted among 179 case of ultrasound images of pernicious placenta previa complicate with placenta accrete, and the results of postpartum were compared. Based on clinical surgery and/or pathological results as the gold standard, all cases were divided into adhesive placenta accreta group and non-adhesive placenta accreta group. Re s ults Logistic regression identified six sonographic parameters, including placenta thickness, obliteration of retroplacental hypoechoic space, smallest sagittal myometrial thickness, presence of abnormal vessels linking the placenta to the bladder, lacunar flow distributed within intraparenchymal placenta area and the cervical form. Different scores were assigned according to the odds ratio of these parameters.The critical score of the ultrasound score of adhesive placenta accreta and non-adhesive placenta was 6 points.Conclus ions Prenatal ultrasonographic scoring system is a reliable method to diagnose the degree of the accretion in pernicious placenta previa complicate with placenta accrete.
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Key words:
- Ultrasonography /
- Placenta accreta /
- Pernicious placenta previa /
- Diagnostic score
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