| 赵新美,吴春燕,李绍雷,吴鹏西.妊娠晚期前置胎盘患者宫颈长度及形态与不良分娩结局的关系[J].中国医学影像技术,2020,36(6): |
| 妊娠晚期前置胎盘患者宫颈长度及形态与不良分娩结局的关系 |
| Relationship between cervical length and morphology and maternal adverse outcomes in patients with placenta previa in the third trimester of pregnancy |
| 投稿时间：2019-05-07 修订日期：2020-06-15 |
| DOI： |
| 中文关键词: 前置胎盘 宫颈长度 胎盘植入 产后出血 剖宫产 超声检查 |
| 英文关键词:Placenta previa Cervical length Placenta accreta Postpartum hemorrhage Cesarean section Ultrasonography |
| 基金项目:无 |
|
| 摘要点击次数: 1960 |
| 全文下载次数: 704 |
| 中文摘要: |
| 目的 探讨妊娠晚期前置胎盘患者宫颈长度（cervical length, CL）及形态与不良分娩结局的关系。 方法 回顾性分析经剖宫产分娩证实为前置胎盘的84例单胎妊娠的超声及临床资料，20例合并胎盘植入，27例发生大出血。以30 mm为临界值，分为研究组（CL≤30 mm，n =21）、对照组（CL＞30 mm,n =63），研究CL与胎盘植入和剖宫产大出血的关系。 结果 研究组、对照组孕妇CL分别为26.9±2.9 mm、38.5±3.4 mm（P <0.001）。单变量分析结果提示：CL≤30 mm、宫颈形态不完整、宫颈血窦患者胎盘植入及剖宫产大出血概率均增加（P <0.1)。多变量分析中，CL≤30 mm是胎盘植入的危险因素。通过ROC曲线得出：CL以35.05 mm为临界值时预测胎盘植入效果最好，其灵敏度、特异度、AUC分别为81.3%、90.0%、0.890（95%CI：0.813-0.967），P <0.001；CL取35.05 mm时预测大出血效果最好，其灵敏度、特异度、AUC分别为82.5%、74.1%、0.814（95%CI：0.717-0.912），P <0.001。 结论 妊娠晚期前置胎盘患者宫颈缩短（CL≤35 mm）、宫颈形态不完整、宫颈血窦与胎盘植入和剖宫产大出血有关，应纳入前置胎盘的评估，并相应地调整治疗方案。 |
| 英文摘要: |
| Objective To explore the relationship between cervical length (CL) and morphology and maternal adverse outcomes in patients with placenta previa in the third trimester of pregnancy . Methods The ultrasonographic and clinical data of 84 singleton pregnancies confirmed as placenta previa by cesarean section were retrospectively analyzed, of which 20 cases with placenta accreta and 27 cases with massive hemorrhage.With 30 mm as the cut-off value, the patients were divided into study group (CL≤30 mm,n =21) and control group (CL > 30 mm,n =63)to investigate the relationship between CL and placenta previa and massive hemorrhage during cesarean section.Results The CL of the study group and the control group was 26.9±2.9 mm and 38.5±3.4 mm, respectively（P <0.001）. In the univariate analysis, the probability of placenta accreta and massive hemorrhage showed increased in patients with CL≤30 mm, cervical morphological incompleteness and cervical sinus（P <0.1).In the multivariate analysis, CL≤ 30 mm was a risk factor for placental accreta.According to the ROC curve, CL with the cut-off value of 35.05 mm had the best prediction of placental accreta, with sensitivity, specificity and AUC of 81.3%, 90.0% and 0.890 (95%CI: 0.813-0.967), respectively, P <0.001.And CL with the cut-off value of 35.05 mm had the best prediction of massive hemorrhage, with sensitivity, specificity and AUC of 82.5%,74.1% and 0.814 (95%CI: 0.717-0.912),respectively,P <0.001. Conclusion Cervical shortening (CL≤35 mm), cervical morphological incompleteness and cervical sinus in the third trimester were related to placenta accreta and massive hemorrhage during cesarean section, should be included in the assessment of placenta previa. And the treatment regimen should be adjusted accordingly. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
