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目的探讨彩色多普勒超声产前诊断脐带入口异常的临床价值。方法行产前超声检查的652例孕妇中诊断为脐带入口异常的孕妇40例,分析孕妇脐带入口异常情况和围产儿的结局。结果诊断为边缘性胎盘脐带入口35例(87.5%),插入部位位于胎盘边缘处,插入部位与胎盘边缘的距离为1.4~1.9(1.6±0.25)cm,其中低置胎盘4例;产前超声检查2例胎盘内低回声区域,产后胎盘检查,胎盘绒毛间隙表现为局灶性的出血。帆状胎盘脐带入口5例,胎儿脐带插入到胎盘表面前属于多个分支,其中3例合并有低置胎盘和胎盘多发的低回声区,产后胎盘的病理检查2例为胎盘绒毛组织纤维素样变性和梗死,形成绒毛膜板血栓1例;40例胎盘脐带入口异常围生儿中,择期行剖宫产的14例(35.00%),急诊剖宫产5例(12.50%),顺产21例(52.50%)。结论产前超声诊断用于胎盘脐带入口异常孕妇的检测及诊断中,不但能及时发现孕妇胎盘的异常,有助于对孕妇的治疗,而且能为孕妇的生产方式提供良好的建议,确保胎儿的成活率,极具临床价值。
Objective To investigate the clinical value of prenatal diagnosis of umbilical cord entrance abnormalities by color Doppler sonography. Methods 40 cases of umbilical cord abnormalities were diagnosed in 652 pregnant women who were diagnosed by prenatal ultrasound. Abnormalities of umbilical cord entrance and the outcome of perinatal children were analyzed. The results of diagnosis of marginal placenta umbilical cord entrance 35 cases (87.5%), the insertion site is located at the edge of the placenta, the insertion site and the edge of the placenta distance 1.4 ~ 1.9 (1.6 ± 0.25) cm, including low placenta in 4 cases; prenatal ultrasound Examination of 2 cases of hypoechoic placental area, postpartum placental examination, placental villous space showed focal bleeding. There were 5 cases of umbilical cord-like placenta intact. The umbilical cord belonged to multiple branches in front of the placenta. Among them, 3 cases had low-placenta accreta and low hypoechoic placenta. Two cases of placental placenta fibroids 1 case of chorion plate thrombosis was formed. Forty cases (35.00%) underwent cesarean section elective cesarean section, 5 cases (12.5%) underwent elective cesarean section and 21 cases (52.50%). Conclusion Prenatal ultrasound diagnosis of placenta umbilical cord entrance abnormalities in the detection and diagnosis of pregnant women can not only timely detection of abnormal placenta, is helpful to the treatment of pregnant women, but also for the production of pregnant women to provide good advice to ensure that the fetus Survival rate, very clinical value.