切换至 "中华医学电子期刊资源库"

中华医学超声杂志(电子版) ›› 2018, Vol. 15 ›› Issue (05) : 355 -358. doi: 10.3877/cma.j.issn.1672-6448.2018.05.006

所属专题: 文献

妇产科超声影像学

胎盘植入的危险因素与超声预警指标的回顾性研究
李勤1,(), 张静秋2, 李春梅3, 吕燕芬2   
  1. 1. 650021 云南省第二人民医院干部体检中心
    2. 650021 云南省第二人民医院超声科
    3. 650021 云南省第二人民医院妇产科
  • 收稿日期:2018-04-22 出版日期:2018-05-01
  • 通信作者: 李勤

Retrospective study on the risk factors and ultrasonic early warning indicators of placental implantation

Qin Li1,(), Jingqiu Zhang2, Chunmei Li3, Yanfen Lyu2   

  1. 1. Department of Cadre′s Health check-up Center, No.2 People′s Hospital of Yunnan Province, Kunming 650021, China
    2. Department of Ultrasound, No.2 People′s Hospital of Yunnan Province, Kunming 650021, China
    3. Department of Obstetrics and Gynecology, No.2 People′s Hospital of Yunnan Province, Kunming 650021, China
  • Received:2018-04-22 Published:2018-05-01
  • Corresponding author: Qin Li
  • About author:
    Corresponding author: Li Qin, Email:
引用本文:

李勤, 张静秋, 李春梅, 吕燕芬. 胎盘植入的危险因素与超声预警指标的回顾性研究[J/OL]. 中华医学超声杂志(电子版), 2018, 15(05): 355-358.

Qin Li, Jingqiu Zhang, Chunmei Li, Yanfen Lyu. Retrospective study on the risk factors and ultrasonic early warning indicators of placental implantation[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(05): 355-358.

目的

探索胎盘植入发生的危险因素及超声预警指标。

方法

连续选取2014年1月至2017年6月在云南省第二人民医院分娩临床及超声诊断胎盘植入46例产妇的临床资料,另选取同期正常分娩无胎盘植入80例产妇(对照组)的临床资料,采用Logistic回归分析等方法分析胎盘植入的危险因素,比较胎盘植入组与对照组产妇各超声异常指标的发生率。

结果

胎盘植入组46例产妇前置胎盘、正常子宫胎盘界面消失、子宫肌层极度变薄、胎盘陷窝、胎盘床血管增多的发生率均较对照组明显增加(P<0.05),是胎盘植入的高危超声表现;年龄、产次、剖宫产史、流产次数是胎盘植入的高危因素(P<0.05)。

结论

针对有胎盘植入高危因素的孕妇,产科医师和超声医师应提高警惕,尤其发现上述高危超声表现时,胎盘植入的可能性明显增加。

Objective

To explore the risk factors and ultrasonic warning indicators of placental accreta.

Methods

Forty-six continuous cases with placental accreta and 80 normal parturients without placenta accreta were included in the study between January 2014 and June 2017 in the No. 2 People′s Hospital of Yunnan Province. The risk factors such as nationality, occupation, educational level, income, parity, the history of cesarean section, age, and number of abortion were analyzed using logistic regression analysis, and the incidences of various ultrasonic indicators were compared between the case group and control.

Results

Age, parity, history of cesarean section and number of abortion were high risk factors for placental accreta (P<0.05). In the case group, the incidence of placenta previa, disappearance of normal placenta interface, extreme thinning of the uterine muscle layer, fossa invagination, and placental bed increased significantly compared with those of the control group (P< 0.05).

Conclusion

For pregnant women with high risk factors of placental accreta, obstetricians and sonographers should be on alert the possibility of placental implantation, especially when such high risk ultrasound findings are found.

表1 胎盘植入组46例产妇流行病学高危因素Logistic回归分析
图4 彩色多普勒血流成像示胎盘陷窝形成(箭头所示)及胎盘床血管增多
表2 胎盘植入产妇与对照组产妇产前超声异常指标检出结果比较[例数(%)]
1
中华医学会围产医学分会, 中华医学会妇产科学分会产科学组. 胎盘植入诊治指南(2015) [J]. 中华围产医学杂志, 2015, 18(7): 481-485.
2
Klemetti R, Che X, Gao Y, et al. Cesarean section delivery among primiparous women in rural China: an emerging epidemic [J]. Am J Obstet Gynecol, 2010, 202(1): 65.e1-6.
3
Jauniaux E, Collins SL, Jurkovic D, et al. Accreta placentation: a systematic review of prenatal ultrasound imaging and grading of villous invasiveness [J]. Am J Obstet Gynecol, 2016, 215(6): 712-721.
4
Silver RM, Landon MB, Rouse DJ, et al. Maternal morbidity associated with multiple repeat cesarean deliveries [J]. Obstet Gynecol, 2006, 107(6): 1226-1232.
5
Usta IM, Hobeika EM, Musa AA, et al. Placenta previa-accreta: risk factors and complications [J]. Am J Obstet Gynecol, 2005, 193(3 Pt 2): 1045-1049.
6
应豪, 阮晟鸣, 王德芬. 胎盘植入的诊治进展 [J]. 实用妇产科杂志, 2007, 3(6): 335-336.
7
郑琼, 李胜利. 胎盘植入产前诊断新进展[J/CD]. 中华医学超声杂志(电子版), 2013, 10(7): 538-541.
8
Collins SL, Ashcroft A, Braun T, et al. Proposal for standardized ultrasound descriptors of abnormally invasive placenta (AIP) [J]. Ultrasound Obstet Gynecol, 2016, 47(3): 271-275.
9
de Castro Rezende G, Araujo Júnior E. Prenatal diagnosis of placenta and umbilical cord pathologies by three-dimensional ultrasound: pictorial essay [J]. Med Ultrason, 2015, 17(4): 545-549.
10
Daney de Marcillac F, Molière S, Pinton A, et al. Accuracy of placenta accreta prenatal diagnosis by ultrasound and MRI in a high-risk population [J]. J Gynecol Obstet Biol Reprod (Paris), 2016, 45(2): 198-206.
11
Meng X, Xie L, Song W. Comparing the diagnostic value of ultrasound and magnetic resonance imaging for placenta accreta: a systematic review and meta-analysis [J]. Ultrasound Med Biol, 2013, 39(11): 1958-1965.
12
D'Antonio F, Iacovella C, Palacios-Jaraquemada J, et al. Prenatal identification of invasive placentation using magnetic resonance imaging: systematic review and meta-analysis [J]. Ultrasound Obstet Gynecol, 2014, 44(1): 8-16.
[1] 章建全, 程杰, 陈红琼, 闫磊. 采用ACR-TIRADS评估甲状腺消融区的调查研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(10): 966-971.
[2] 罗辉, 方晔. 品管圈在提高甲状腺结节细针穿刺检出率中的应用[J/OL]. 中华医学超声杂志(电子版), 2024, 21(10): 972-977.
[3] 杨忠, 时敬业, 邓学东, 姜纬, 殷林亮, 潘琦, 梁泓, 马建芳, 王珍奇, 张俊, 董姗姗. 产前超声在胎儿22q11.2 微缺失综合征中的应用价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(09): 852-858.
[4] 孙佳丽, 金琳, 沈崔琴, 陈晴晴, 林艳萍, 李朝军, 徐栋. 机器人辅助超声引导下经皮穿刺的体外实验研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(09): 884-889.
[5] 史学兵, 谢迎东, 谢霓, 徐超丽, 杨斌, 孙帼. 声辐射力弹性成像对不可切除肝细胞癌门静脉癌栓患者放射治疗效果的评价[J/OL]. 中华医学超声杂志(电子版), 2024, 21(08): 778-784.
[6] 李洋, 蔡金玉, 党晓智, 常婉英, 巨艳, 高毅, 宋宏萍. 基于深度学习的乳腺超声应变弹性图像生成模型的应用研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(06): 563-570.
[7] 洪玮, 叶细容, 刘枝红, 杨银凤, 吕志红. 超声影像组学联合临床病理特征预测乳腺癌新辅助化疗完全病理缓解的价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(06): 571-579.
[8] 项文静, 徐燕, 茹彤, 郑明明, 顾燕, 戴晨燕, 朱湘玉, 严陈晨. 神经学超声检查在产前诊断胼胝体异常中的应用价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(05): 470-476.
[9] 胡可, 鲁蓉. 基于多参数超声特征的中老年女性压力性尿失禁诊断模型研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(05): 477-483.
[10] 张妍, 原韶玲, 史泽洪, 郭馨阳, 牛菁华. 小肾肿瘤超声漏诊原因分析新思路[J/OL]. 中华医学超声杂志(电子版), 2024, 21(05): 500-504.
[11] 席芬, 张培培, 孝梦甦, 刘真真, 张一休, 张璟, 朱庆莉, 孟华. 乳腺错构瘤的临床与超声影像学特征分析[J/OL]. 中华医学超声杂志(电子版), 2024, 21(05): 505-510.
[12] 钱警语, 郑明明. 《2024意大利妇产科学会非侵入性和侵入性产前诊断指南》解读[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 486-492.
[13] 李霞林, 贺芳. 产后出血风险评估和早期预警系统[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 498-503.
[14] 张琛, 秦鸣, 董娟, 陈玉龙. 超声检查对儿童肠扭转缺血性改变的诊断价值[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 565-568.
[15] 陈秀晓, 隋文倩, 王珉鑫, 吴圆圆. 腹股沟斜疝并腹腔游离体超声表现一例[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 516-517.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?