[1]帥秀芳,鄭 慧.彩色多普勒超聲診斷帆狀胎盤和血管前置的臨床價值及漏診誤診原因分析[J].醫學信息,2019,(20):164-166.[doi:10.3969/j.issn.1006-1959.2019.20.052]
 SHUAI Xiu-fang,ZHENG Hui.Clinical Value of Color Doppler Ultrasound in Diagnosis of Spiral Placenta and Vascular Preposition and Analysis of Misdiagnosis Causes of Missed Diagnosis[J].Medical Information,2019,(20):164-166.[doi:10.3969/j.issn.1006-1959.2019.20.052]
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彩色多普勒超聲診斷帆狀胎盤和血管前置的臨床價值及漏診誤診原因分析()
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醫學信息[ISSN:1006-1959/CN:61-1278/R]

卷:
期數:
2019年20期
頁碼:
164-166
欄目:
診療技術
出版日期:
2019-10-15

文章信息/Info

Title:
Clinical Value of Color Doppler Ultrasound in Diagnosis of Spiral Placenta and Vascular Preposition and Analysis of Misdiagnosis Causes of Missed Diagnosis
文章編號:
1006-1959(2019)20-0164-03
作者:
帥秀芳鄭 慧
(安徽醫科大學第一附屬醫院超聲科,安徽 合肥 230000)
Author(s):
SHUAI Xiu-fangZHENG Hui
(Department of Ultrasound,the First Affiliated Hospital of Anhui Medical University,Hefei 230000,Anhui,China)
關鍵詞:
帆狀胎盤血管前置產前超聲
Keywords:
Spiral placentaVascular prepositionPrenatal ultrasound
分類號:
R445
DOI:
10.3969/j.issn.1006-1959.2019.20.052
文獻標志碼:
A
摘要:
目的 探討產前彩色多普勒超聲診斷帆狀胎盤及血管前置的臨床價值及漏診和誤診原因分析。方法 回顧性分析2015年1月~2018年7月我院行產前彩色多普勒超聲篩查946例孕婦的彩色多普勒聲像圖及臨床特點,分析帆狀胎盤和血管前置的超聲診斷情況、影像學特點及妊娠結局。結果 共946例孕婦中,產科證實帆狀胎盤117例,超聲診斷帆狀胎盤106例,漏診11例,誤診7例,漏診率:9.40%(11/117),誤診率:0.84%(7/829),診斷符合率:98.10%(928/946);產科證實血管前置19例,超聲診斷血管前置16例,漏診3例,誤診3例;漏診率:15.79%(3/19),誤診率:0.32%(3/727),診斷符合率:99.37%(940/946)。帆狀胎盤彩色多普勒超聲顯示臍帶入口在胎盤邊緣的游離胎膜內,經羊膜和絨毛膜之間進入胎盤;血管彩色多普勒超聲顯示胎膜血管位于胎兒先露前方跨越宮頸內口或者接近宮頸內口。有69.91%(79/113)的超聲帆狀胎盤孕婦選擇剖宮產,另外30.09%(34/113)選擇順產;有19例產前超聲診斷為血管前置孕婦均選擇剖宮產,其中5例胎膜早破急診剖宮產手術,但新生兒情況良好。結論 彩色多普勒超聲能較好的顯示胎盤形狀、胎盤臍帶插入口位置及宮頸內口血管情況,提高診斷帆狀胎盤及血管前置診斷率,改善妊娠結局,降低圍生期胎兒死亡率,但因各種因素影響,存在一定漏診和誤診。
Abstract:
Objective To investigate the clinical value of prenatal color Doppler ultrasound in the diagnosis of sacral placenta and vascular preposition and the reasons for missed diagnosis and misdiagnosis. Methods Retrospective analysis of color Doppler sonography and clinical features of 946 pregnant women undergoing prenatal color Doppler ultrasound screening from January 2015 to July 2018, and analysis of the ultrasound of the placenta and vascular front Diagnostic conditions, imaging features and pregnancy outcomes. Results Among 946 pregnant women, 117 cases of sail-shaped placenta were confirmed by obstetrics, 106 cases of spiral placenta were diagnosed by ultrasound, 11 cases were missed, and 7 cases were misdiagnosed. The rate of missed diagnosis was 9.40% (11/117), and the rate of misdiagnosis was 0.84% (7/829), the diagnostic coincidence rate: 98.10% (928/946); obstetrics confirmed 19 cases of vascular advancement, 16 cases of anterior ultrasound diagnosis, 3 cases of missed diagnosis, 3 cases of misdiagnosis; the rate of missed diagnosis: 15.79% (3/19), The rate of misdiagnosis was 0.32% (3/727), and the diagnostic coincidence rate was 99.37% (940/946). Spiral placenta color Doppler ultrasound showed that the umbilical cord entrance was in the free fetal membrane at the edge of the placenta, entering the placenta between the amnion and the chorion; vascular color Doppler ultrasound showed that the fetal membrane blood vessels were located in front of the fetus to cross the cervix or close to the cervix. 69.91% (79/113) of the patients with ultrasonic sail-shaped placenta chose cesarean section, and another 30.09% (34/113) chose to give birth. There were 19 cases of prenatal ultrasound diagnosis for vascular anterior women who chose cesarean section, of which 5 cases of premature rupture of membranes for emergency cesarean section, but the newborn is in good condition. Conclusion Color Doppler ultrasound can better display the shape of the placenta, the position of the placenta of the placenta and the vascular part of the cervix, improve the diagnostic rate of the placenta and vascular preamplifier, improve the pregnancy outcome, and reduce the perinatal fetal mortality. However, due to various factors, there are certain missed diagnosis and misdiagnosis.

參考文獻/References:

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更新日期/Last Update: 2019-10-15
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