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

doi:10.3877/cma.j.issn.1672-6448.2018.05.006

Abstract

Abstract:

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.

Key words: Ultrasonography, Placenta accreta, Early warning

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

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2018.05.006

https://chaosheng.cma-cmc.com.cn/EN/Y2018/V15/I05/355

Figures/Tables 3

References 12

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.

高危因素	回归系数	wald值	OR	95% CI	P值
年龄	-0.200	9.741	0.819	0.722~0.928	0.002
产次	1.677	6.017	5.348	1.41~20.42	0.014
剖宫产史	5.316	17.411	203.486	16.756~2471.077	<0.001
流产次数	-0.353	8.720	0.703	0.556~0.888	0.003
常量	-2.157	0.440	0.116	?	0.507

高危因素	回归系数	wald值	OR	95% CI	P值
年龄	-0.200	9.741	0.819	0.722~0.928	0.002
产次	1.677	6.017	5.348	1.41~20.42	0.014
剖宫产史	5.316	17.411	203.486	16.756~2471.077	<0.001
流产次数	-0.353	8.720	0.703	0.556~0.888	0.003
常量	-2.157	0.440	0.116	?	0.507

分组	例数	前置胎盘	胎盘插入口异常	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
对照组	80	0（0）	4（0.05）	0（0）	0（0）	0（0）	0（0）
胎盘植入组	46	40（86.96）^a	3（6.52）	3（6.52）^a	5（10.87）^a	2（4.35）^a	14（30.43）^a
P值	?	0.002	0.507	0.014	<0.001	0.003	0.015

分组	例数	前置胎盘	胎盘插入口异常	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
对照组	80	0（0）	4（0.05）	0（0）	0（0）	0（0）	0（0）
胎盘植入组	46	40（86.96）^a	3（6.52）	3（6.52）^a	5（10.87）^a	2（4.35）^a	14（30.43）^a
P值	?	0.002	0.507	0.014	<0.001	0.003	0.015

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