妊娠合并梅毒患者产前超声的监测研究

摘要

目的:探讨产前超声对妊娠合并梅毒临床价值.方法:随机选取2012年3月至2015年3月62例妊娠合并梅毒患者为研究对象,均予超声检查,在入院前超声检查前已规范抗梅治疗作为治疗组,共51例,余11例为未治疗组,将治疗组根据孕周不同分成孕早期组(≤12周)、孕中期组(12～28周)、孕晚期组(≥28周),分别为18例、21例、12例,比较各组相关指标变化.结果:妊娠合并梅毒超声以胎盘水肿、胎儿各类畸形、胎儿水肿、胎儿宫内窘迫为主要表现,其中孕期越晚治疗则超声异常发生率越高,未治疗组流产、死胎、胎儿宫内窘迫、胎儿各类畸形、胎盘异常发生率显著高于其他组别,和其他三组比较有统计学意义(P＜0.05);未治疗者以流产和死胎为主,共10例,先天性梅毒1例,占9.09％,早期规范治疗梅毒则正常新生儿出生率越高,孕早期、孕中期、孕晚期、未治疗脐动脉血流收缩期峰值/舒张末期谷值(S/D值)分别为(1.56±0.14)、(1.71±0.16)、(2.51-0.19)、(4.43±0.23),未治疗组和其他三组比较差异显著(P＜0.05).结论:产前超声能显示妊娠合并梅毒胎儿异常情况,且能预测胎儿预后临床价值高.%Objectives:To investigate the clinical value of prenatal ultrasound for pregnant women with syphilis.Methods:62 pregnant women with syphilis enrolled from March 2012 to March 2015 were selected and given prenatal ultrasound.51 patients had received treatment for syphilis before were as the treated group and the rest 11 cases were the untreated group.The treated group was further divided according to the gestational age into early pregnancy group (≤ 12 weeks),second trimester group (12-28 weeks) and third trimester group (≥ 28weeks),with 18 cases,21 cases and 12 cases respectively.Related indexes were compared between different groups.Results:In pregnant women with syphilis,the main manifestation included placenta edema,various types of fetal malformations,fetal hydrops and fetal distress,where the later the treatment was,the higher the incidence was.The incidence of miscarriage,stillbirth,fetal distress,various types of fetal abnormalities and placental abnormalities were significantly higher in the untreated group than other groups,with statistically significance (P ＜0.05).There were 10 cases of abortion and stillbirth and a case (9.09％) of congenital syphilis.The rate of normal newborns in treated group was higher.The umbilical artery peak systolic / diastolic end of the valley (S/D value) at early pregnancy,second trimester and third trimester of pregnancy and untreated group were (1.56 ± 0.14),(1.71 ±0.16),(2.51 ±0.19) and (4.43 ±0.23) respectively,with significantly difference between the untreated group and the other three groups (P ＜ 0.05).Conclusion:Prenatal ultrasound can show the fetal abnormalities of pregnant women with syphilis,and has high clinical value in predicting fetal outcome.