王珊珊, 王莉, 吴青青, 张娜. 子宫动脉血流联合多参数对胎盘植入性疾病的诊断价值研究[J]. 协和医学杂志. DOI: 10.12290/xhyxzz.2024-0171
引用本文: 王珊珊, 王莉, 吴青青, 张娜. 子宫动脉血流联合多参数对胎盘植入性疾病的诊断价值研究[J]. 协和医学杂志. DOI: 10.12290/xhyxzz.2024-0171
WANG Shanshan, WANG Li, WU Qingqing, ZHANG Na. Value of Uterine Artery Blood Flow Associated with Multiple Parameters in the Diagnosis of Placenta Accreta Spectrum Disorders[J]. Medical Journal of Peking Union Medical College Hospital. DOI: 10.12290/xhyxzz.2024-0171
Citation: WANG Shanshan, WANG Li, WU Qingqing, ZHANG Na. Value of Uterine Artery Blood Flow Associated with Multiple Parameters in the Diagnosis of Placenta Accreta Spectrum Disorders[J]. Medical Journal of Peking Union Medical College Hospital. DOI: 10.12290/xhyxzz.2024-0171

子宫动脉血流联合多参数对胎盘植入性疾病的诊断价值研究

Value of Uterine Artery Blood Flow Associated with Multiple Parameters in the Diagnosis of Placenta Accreta Spectrum Disorders

  • 摘要: 目的 探讨子宫动脉血流联合多参数在胎盘植入性疾病诊断中的应用价值。方法 本研究为回顾性队列研究, 选取 2017 年 1 月—2021 年 12 月就诊于首都医科大学附属北京妇产医院且诊断为前置胎盘的孕妇为研究对象。通过医院电子病历系统获取孕妇的一般资料、既往史、产检信息、手术信息。 根据手术结果将其分为胎盘植入组与非植入组。 结果 共纳入符合纳排标准的孕妇 80 例,其中植入组 34 例,非植入组 46 例。 与非植入组相比,植入组孕妇的年龄(P=0.017)、剖宫产史(P<0.001)均显著升高, 子宫动脉平均搏动指数(pulsatility index, PI) 显著降低(P=0.006), 胎盘后低回声带局部中断或消失(P<0.001)、胎盘后丰富血流(P<0.001)、 子宫膀胱交界线中断或消失或不规则(P=0.003)等超声征象均具有显著性差异; 子宫动脉平均 PI 值、剖宫产史、超声征象三者联合诊断胎盘植入性疾病的 ROC 曲线下面积为 0.96(95% CI: 0.93~0.99), 灵敏度为 97.06%(95% CI:0.91~1.00),特异度为 65.22%(95% CI: 0.51~0.79)。 结论 子宫动脉血流 PI 值联合多参数预测胎盘植入性疾病具有一定的诊断价值。

     

    Abstract: Objective To explore the application value of uterine artery blood flow associated with multiple parameters in the diagnosis of placenta accreta spectrum disorders. Methods This study was a retrospective cohort study. Pregnant women diagnosed with placenta previa were selected from Beijing Obstetrics and Gynecology Hospital, Capital Medical University, from January 2017 to December 2021. The general information, past history, antenatal information and operation information of the pregnant women were obtained through the hospital electronic medical record system. According to the results of operation, the patients were divided into accreta group and non-accreta group. Results A total of 80 pregnant women were divided into accreta group (34 cases) and non-accreta group (46 cases) according to the inclusion and exclusion criteria. Compared with the non-accreta group, the age of pregnant women in the accreta group (P=0.017) and history of cesarean section (P<0.001) significantly increased, and the mean pulsatility index (PI) of uterine artery significantly decreased (P=0.006). There were significant differences in ultrasonic signs such as local interruption or disappearance of the posterior placental lower vocal cords (P<0.001), abundant blood flow after placenta (P<0.001), and interruption or disappearance or irregularity of the boundary of the uterus and bladder (P=0.003). The area under the ROC curve of uterine artery PI, cesarean section history and ultrasonic signs in the diagnosis of placenta accreta spectrum disorders was 0.96( 95% CI: 0.93~0.99), the sensitivity was 97.06%( 95% CI:0.91~1.00), and the specificity was 65.22%( 95% CI: 0.51~0.79). Conclusion Uterine artery blood flow PI associated with multiple parameters has certain diagnostic value in the prediction of placenta accreta spectrum disorders.

     

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