摘要
目的探讨彩色多普勒超声产前评估血管前置的临床价值。方法回顾性分析2016年1月至2018年4月在广州市妇女儿童医疗中心分娩确诊的35例血管前置患者的临床资料、超声图像特征及分娩结局。结果产前经腹部彩色多普勒超声诊断25例,经腹部联合经阴道彩色多普勒超声诊断7例,诊断符合率为91.4%(32/35),漏诊率为5.7%(2/35),误诊率为2.8%(1/35),晚孕期误诊为脐带先露。其中前置胎盘或低置胎盘合并帆状胎盘22例,帆状胎盘8例,副胎盘2例,分叶状胎盘2例,前置胎盘合并球拍状胎盘1例。33例胎儿行择期剖腹产,新生儿Apgar’s评分正常;1例漏诊病例足月因前置血管破裂胎心异常行紧急剖腹产,新生儿重度窒息;另1例漏诊病例顺产过程中前置血管破裂行钳产助产分娩一成熟活婴,新生儿轻度窒息。结论经腹部联合经阴道彩色多普勒超声可以较准确诊断胎儿血管前置,对临床分娩方式、时间选择及改善围产儿预后有重要参考价值。
Objective To explore the value of prenatal ultrasound color Doppler in diagnosing vasa previa.Methods Clinical data,ultrasound features and labor outcomes of thirty-five patients admitted to our hospital for vasa previa after birth were analyzed retrospectively.Results Twenty-five patients were found to have vasa previa by transabdominal ultrasound and 7 patients were diagnosed with it by transabdominal ultrasound combined with a subsequent transvaginal color Doppler.The detection rate was 91.4%(32/35),and the missed diagnosis rate was 5.7%(2/35),and the misdiagnosis rate was 2.8%(1/35),and it was misdiagnosed as umbilical cord exposure in late pregnancy.Of all the cases,22 cases were diagnosed as having placenta previa or low-lying placenta combined with velamentous placenta,8 cases having velamentous placenta,2 cases having accessory placenta,2 cases haing bi-lobe placenta,1 case having placenta previa with battledore placenta.33 cases received elective caesarean section,and the Apgar’s scores were normal.One case missed diagnosis experience emergency caesarean section was implemented for one case of missed diagnosis because of abnormality of fetal heart with ruptured vessels,the newborn infant experiencing severe asphyxia.Another case of missed diagnosis received forceps delivery because of the rupture of previa vessels,the newborn infant experiencing mild asphyxia.Conclusion Abdominal combined with transvaginal color Doppler ultrasonographycan accurately diagnose fetal vasa previa,which is of great reference value for clinical delivery approach,time selection and improvement of perinatal prognosis.
作者
颜璨
王红英
沙晓燕
王海玉
黄丹萍
李晓菲
YAN Can;WANG Hongying;SHA Xiaoyan;WANG Haiyu;HUANG Danping;LI Xiaofei(Department of Ultrasonography,Guangzhou Women and Childrens Medical Center,Guangzhou 510623,Guangdong,China;Department of Obstetrics,Guangzhou Women and Childrens Medical Center,Guangzhou 50623,Guangdong,China)
出处
《中国妇幼健康研究》
2019年第12期1600-1603,共4页
Chinese Journal of Woman and Child Health Research
基金
广州市卫生健康科技项目(编号:20191A010025)
关键词
血管前置
联合检查
彩色多普勒超声
产前诊断
妊娠结局
vasa previa
combined screening
color doppler ultrasonography
prenatal diagnosis
pregnancy outcome
