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目的:分析胎盘植入超声声像学特征,分析诊断错误影响因素,总结诊断管理经验。方法:2014年1月~2016年6月,诊断胎盘植入98例,将产前诊断者纳入产前诊断组,产前误漏诊者纳入产后诊断组,进行因素分析。结果:产前明确诊断率34.69%(34/98),漩涡形成35.7%、胎盘后间隙消失29.6%、局部子宫肌层菲薄16.3%;产前诊断者有子宫内膜损伤病史、前置胎盘、瘢痕子宫、漩涡征、胎盘后间隙消失、局部子宫肌层菲薄、宫内窘迫/胎儿发育异常、超声质量优、责任医师工龄≥10年比重高于产后诊断组,差异具有统计学意义(P<0.05)。结论:胎盘植入的产前超声诊断较困难,应予以重视,对于不伴有子宫内膜损伤病史等危险因素的产妇也应予以重视,对于疑难病例,应进行联合诊断。
OBJECTIVE: To analyze the features of placenta accreta ultrasound, analyze the influencing factors of diagnosis errors and summarize the experience of diagnosis management. Methods: From January 2014 to June 2016, 98 cases of placenta accreta were diagnosed. The prenatal diagnosis was included in the prenatal diagnosis group. The prenatal diagnosis of misdiagnosis was included in the postnatal diagnosis group for factor analysis. Results: The prenatal diagnosis rate was 34.69% (34/98), 35.7% of whirlpool formation, 29.6% of placental space disappearance, and 16.3% of local myometrial thinness. Prenatal diagnosis of endometrial injury history, placenta previa, The uterus scarring, vortex sign, the disappearance of the placental space, the local myometrium meager, intrauterine distress / fetal development abnormalities, excellent ultrasound quality, the responsible physician for more than 10 years of service life than the postpartum diagnosis group, the difference was statistically significant (P < 0.05). Conclusions: Prenatal ultrasound diagnosis of placenta accretion is more difficult and should be paid attention to. Women who are not associated with risk factors such as history of endometrial trauma should also be paid attention to, and for difficult cases, joint diagnosis should be carried out.