摘要
目的 分析剖宫产后再次妊娠胎盘植入在妊娠早期的超声声像图特点及其诊断价值。方法 选取31例剖宫产后再次妊娠早期胎盘植入患者作为观察组,再选取同期31例剖宫产后再次妊娠早期胎盘附着子宫前壁且覆盖宫颈口内未发现胎盘植入患者作为对照组。比较两组妊娠早期超声声像图像特征(包括子宫浆膜膀胱交界血流信号丰富、胎盘实质内腔隙血流、胎盘后方子宫肌层变薄、胎盘后方低回声区异常检出率),分析超声检查诊断胎盘植入的效能(包括灵敏度、特异度、诊断符合率)。结果 观察组患者子宫浆膜膀胱交界血流信号丰富、胎盘实质内腔隙血流、胎盘后方子宫肌层变薄、胎盘后方低回声区异常检出率分别为22.58%、22.58%、19.35%、32.26%,均高于对照组的0、0、0、3.23%,差异具有统计学意义(P<0.05)。以手术病理检查结果为金标准,超声诊断胎盘植入的灵敏度为83.87%(26/31),特异度为93.55%(29/31),诊断符合率为88.71%(55/62)。结论 超声检查诊断剖宫产后再次妊娠早期胎盘植入具有较高的检出率,超声声像图表现明显,有利于为临床处理提供影像支持,减少不良结果发生率,具有较高临床推广价值。
Objective To analyze the ultrasonographic features of placenta accreta in early pregnancy and its diagnostic value in second pregnancies after cesarean section.Methods 31 patients with placenta accreta in early pregnancy after cesarean section were selected as the observation group,and 31 patients with placenta accreta in early pregnancy after cesarean section during the same period were selected as the control group.The ultrasonographic features in early pregnancy of the two groups were compared(including abundant blood flow signals at the uterine serosa-vesical junction,intraparenchymal blood flow in the placenta,thinning of the myometrium in the posterior placenta,and abnormality in the hypoechoic area in the posterior placenta),and the efficacy of ultrasonography in diagnosing placenta accreta(including sensitivity,specificity,and diagnostic coincidence rate)was analyzed.Results The detection rate of abundant blood flow signals at the uterine serosavesical junction,intraparenchymal blood flow in the placenta,thinning of the myometrium in the posterior placenta,and abnormality in the hypoechoic area in the posterior placenta of the observation group were 22.58%,22.58%,19.35%,and 32.26%,which were higher than 0,0,0,and 3.23%of the control group,and the differences were all statistically significant(P<0.05).Taking surgical and pathological examination results as the gold standard,the sensitivity of ultrasonography in the diagnosis of placenta accreta was 83.87%(26/31),the specificity was 93.55%(29/31),and the diagnostic coincidence rate was 88.71%(55/62).Conclusion Ultrasonography has a high detection rate for the diagnosis of early placenta accreta in second pregnancies after cesarean section,the ultrasonographic performance is obvious,which is conducive to providing image support,reducing the incidence of adverse results,and has high promotion value.
作者
赵维一
ZHAO Wei-yi(Ultrasonography Department,Dalian Women and Children Medical Center,Dalian 116600,China)
出处
《中国实用医药》
2022年第23期97-99,共3页
China Practical Medicine
关键词
剖宫产
再次妊娠
早期
胎盘植入
超声声像图
Cesarean section
Second pregnancies
Early
Placenta accreta
Ultrasonographic image
