摘要
目的探究彩色多普勒血流成像(CDFI)对孕期帆状胎盘的诊断价值,并探究其对产妇妊娠结局的预测价值。方法对2018年3月至2022年3月在宁德师范学院附属宁德市医院生产的98例产后诊断为帆状胎盘的孕妇的临床资料进行回顾性分析,所有孕妇孕期均接受CDFI检查,并分析其影像学资料,观察其帆状胎盘检出情况。根据产妇的妊娠结局将其分组,分为良好结局组(n=52)和不良结局组(n=46)。比较两组间临床资料(年龄、舒张压、收缩压、空腹血糖、羊水指数、分娩方式)及超声血流参数[脐动脉和大脑中动脉收缩期峰值流速/舒张末期流速(S/D)、阻力指数(RI)]情况,并采用受试者操作特征(ROC)曲线分析CDFI血流参数对产妇妊娠结局的预测价值。结果98例产后诊断为帆状胎盘的孕妇,在孕16~18周时CDFI确诊为帆状胎盘66例,检出率为67.35%;在孕24~26周时确诊91例,检出率为92.86%;在孕31~33周时确诊94例,检出率为95.92%。不良结局组与良好结局组在年龄、舒张压、收缩压、空腹血糖、羊水指数方面比较,差异均无统计学意义(P>0.05);不良结局组剖宫产患者占比为78.26%,高于良好结局组(21.15%),差异有统计学意义(P<0.05)。不良结局组患者脐动脉S/D、RI水平分别为3.12±0.31、0.72±0.04,均高于良好结局组(2.99±0.12、0.65±0.03),大脑中动脉S/D、RI水平分别为3.31±0.29、0.51±0.05,均低于良好结局组(5.55±0.36、0.80±0.06),差异均有统计学意义(P<0.05)。脐动脉S/D、RI及大脑中动脉S/D、RI对产妇妊娠结局具有一定的预测价值,其曲线下面积值分别为0.679、0.920、0.890、0.809,最佳截断值分别为3.175、0.685、4.620、0.625。结论CDFI对孕期帆状胎盘具有较高的检出率,且脐动脉和大脑中动脉的血流参数能够对孕妇的妊娠结局进行有效预测,可以在临床推广应用。
Objective To explore the diagnostic value of color doppler flow imaging(CDFI)on sail placenta during pregnancy and its predictive value for pregnancy outcome.Methods The clinical data of 98 pregnant women diagnosed with sail placenta in Ningde Hospital,Ningde Normal University from March 2018 to March 2022 were retrospectively analyzed.All pregnant women underwent CDFI examination during pregnancy,and their imaging data were analyzed to observe the detection of sail placenta.According to the maternal pregnancy outcomes,they were divided into the good outcome group(n=52)and the bad outcome group(n=46).The clinical data(age,diastolic blood pressure,systolic blood pressure,fasting blood glucose,amniotic fluid index,mode of delivery)and ultrasound flow parameters[umbilical artery and middle cerebral artery systolic peak velocity/end diastolic velocity(S/D),resistance index(RI)]were compared between the two groups,and the predictive value of CDFI blood flow parameters on maternal pregnancy outcome was analyzed using the receiver operating characteristic(ROC)curve.Results In 98 pregnant women diagnosed with sail placenta,66 women at 16-18 weeks,with a detection rate of 67.35%;91 women at 24-26 weeks,92.86%;94 women at 31-33 weeks,with a detection rate of 95.92%.There was no significant difference in age,diastolic blood pressure,systolic blood pressure,fasting blood glucose and amniotic fluid index between the adverse outcome group and the good outcome group(P>0.05).The proportion of cesarean section patients in the adverse outcome group was 78.26%,which was higher than that in the good outcome group(21.15%),and the difference was statistically significant(P<0.05).The levels of umbilical artery S/D and RI in the adverse outcome group were 3.12±0.31 and 0.72±0.04,respectively,which were higher than those in the good outcome group(2.99±0.12 and 0.65±0.03),the levels of middle cerebral artery S/D and RI were 3.31±0.29 and 0.51±0.05,respectively,which were lower than those in the good outcome group(5.55±0.36 and 0.80±0.06),and the differences were statistically significant(P<0.05).Umbilical artery S/D,RI and middle cerebral artery S/D,RI had certain predictive value for maternal pregnancy outcome.The area values under the curve were 0.679,0.920,0.890 and 0.809,respectively,and the optimal cut-off values were 3.175,0.685,4.620 and 0.625,respectively.Conclusion CDFI has a high detection rate for sail placenta,and the blood flow parameters of umbilical artery and middle cerebral artery can effectively predict the pregnancy outcome of pregnant women,which can be used in clinical practice.
作者
张松美
魏秀霞
陈庆城
ZHANG Song-mei;WEI Xiu-xia;CHEN Qing-cheng(Department of Ultrasound,Ningde Hospital,Ningde Normal University,Ningde Fujian 352100,China)
出处
《临床和实验医学杂志》
2024年第23期2554-2557,共4页
Journal of Clinical and Experimental Medicine
基金
福建省宁德市医技提升科研项目(编号:2018-137)。
关键词
彩色多普勒超声
血流参数
帆状胎盘
妊娠结局
Color doppler ultrasound
Pregnancy outcome and blood flow parameters
Sail placenta
Pregnancy outcome
作者简介
通信作者:陈庆城,Email:812292360@qq.com。
