帆状胎盘及球拍状胎盘产前应用超声诊断的临床意义

摘要

目的：探讨产前应用超声诊断帆状胎盘及球拍状胎盘的临床意义。方法以2010年9月—2013年9月入该院治疗的经产后证实为帆状胎盘及球拍状胎盘的32例孕妇为观察对象，以非帆状胎盘及球拍状胎盘为对照组，比较两组孕妇的临床特点和超声诊断情况。结果观察组32例病例中孕周<28周的孕妇超声诊断符合率高于孕周≥28周的孕妇，差异有统计学意义（P<0.05）；产前超声诊断显示有10例为帆状胎盘，17例为球拍状胎盘，诊断符合率为84.38%（27/32），漏诊5例，包括2例帆状胎盘和3例球拍状胎盘；对照组除单脐动脉发生率与观察组比较无明显差异外，多胎、前置胎盘、早产、死胎发生率和围生儿死亡率均低于观察组，差异有统计学意义（P<0.05）。结论产前应用超声诊断帆状胎盘及球拍状胎盘是提高胎儿存活率和降低并发症的重要措施，值得临床借鉴和推广。%Objective To investigate the clinical significance of prenatal application of ultrasonography for the diagnosis of vela-mentous placenta and battledore placenta. Methods 32 pregnant women postpartum confirmed with velamentous placenta or bat-tledore placenta in our hospital from September 2010 to September 2013 were selected as the object of observation. And those pregnant women with non-velamentous placenta or non-battledore placenta were selected as the control group. The clinical fea-tures and ultrasonic diagnosis of the two groups of pregnant women were compared. Results Of the 32 cases in the observation group, the accordance rate of ultrasonic diagnosis of pregnant women with gestational age <28 weeks was higher than that of the pregnant women with gestational age≥28 weeks, the difference was statistically significant (P<0.05); prenatal ultrasonic diagnosis showed that there were 10 cases with velamentous placenta, and 17 cases with battledore placenta, the accordance rate of ultra-sonic diagnosis was 84.38%(27/32); there were 5 cases of missed diagnosis, including 2 cases with velamentous placenta, 3 cases with battledore placenta; the difference in the incidence of single umbilical artery between the observation group and the control group was not statistically significant, but the differences in the incidences of multiple pregnancy, placenta previa, premature birth, stillbirth and perinatal mortality rate between the two groups were statistically significant (P<0.05). Conclusion Prenatal ultrasonic diagnosis of velamentous placenta and battledore placenta is an important measure for improving the fetal survival rate and reduc-ing the complications, which is worthy of clinical reference and promotion.