摘要
目的:探讨稽留流产的超声表现,及时诊断出胚胎、胎儿停止发育或胚胎残留,配合临床及时采取合理治疗措施和治疗中的超声监测,减少产妇的并发症。方法回顾性分析经手术或病理证实的183例稽留流产患者的临床资料及声像图表现。总结其超声特点及超声辅助的治疗方法。结果稽留流产声像表现根据其影像特点分为四型:胚胎停止发育型,孕囊平均直径>2.0cm,囊内可见胚芽存在,未探及原始心管搏动,其中孕囊平均直径<1.0cm者,囊内未见胚芽或仅见卵黄囊存在,经过1~2w观察孕囊不增大者,应考虑胚胎停止发育。枯萎孕卵型,宫腔内孕囊圆而饱满(>8w),内无胎芽或仅见一小胎块[1-2]。胎儿停止发育型,胎儿形态可辨但已去常态,实时超声检查看不到胎心搏动或胎动。杂乱回声型,宫腔内既看不清胎儿也看不清胎盘组织,只见混乱一团结构。所有稽留流产患者均经超声及临床资料证实,治疗均口服米非司酮配伍米索前列醇终止妊娠,3d后复查阴道彩超。其中有57例患者阴道彩超诊断宫腔残留物,采用经腹超声引导下清宫处理。所有患者均建议1w后彩超复查。结论超声对稽留流产的认识具有重要的临床意义,在选择治疗方案指导治疗及治疗后随诊方面起重要作用。
Objective Discussion on ultrasonic manifestation of missed abortion,prompt diagnosis the embryos stop developing or residual embryos,timely take reasonable remedial measures and clinical ultrasound monitoring during treatment,reduction of maternal complications.Methods Retrospective analysis of surgery or pathology of the 183 cases of missed abortion patient's clinical data and imaging performance.Results Characteristics summarized its ultrasound and ultrasound-assisted treatments.Missed abortion video based on its imaging features are grouped into four types:the embryos stop developing reproductive,capsule average diameter>2.0CM,SAC visible embryo,study and primitive heart tube is not beating in which pregnant capsule average diameter<1.0cm,SAC no germ or has never been a yolk sac,fetal SAC does not increase after 1-2 weeks of observation should be considered embryos stop developing.Wither pregnant egg type,ful of uterine tube Cyst(﹥8 weeks),without fetal buds or side-a smal Mole.Baby stop developing fetal forms can be identified but has been normal,ultrasound can't check to see if the fetal heart beat or fetal movements.Hybrid-echo,which did not see the fetus intrauterine couldn't also placental tissue,and chaotic structure.Al missed abortion patients are confirmed by ultrasound and clinical data,treatment of oral mifepristone coadministered with misoprostol on terminating pregnancy,review the transvaginal color Doppler ultrasonography after 3 days.57 patients with transvaginal color Doppler ultrasound in diagnosis of intrauterine residue by transabdominal ultrasound-guided Palace.Al are recommended in patients with color Doppler ultrasound in a week for review.Conclusions Ultrasound awareness of missed abortion is of great significance,in the choice of treatment programme plays an important role in the treatment and fol ow-up after treatment.
作者
郑敏
ZHENG Min(Anhui Province Suixi County Hospital of Traditional Chinese Medical,Department of Diagnostic Ultrasound,Suixi Anhui,235100,China)
关键词
稽留流产
超声
影像表现
Missed abortion
Ultrasonography
Diagnostic imaging
