YANG Hong, LAN Ruihong, HONG Yan, SONG Jie, GONG Humin. First-trimester versus second- and third-trimester pregnancy in prenatal ultrasonographic features of placenta accreta[J]. Journal of Clinical Medicine in Practice, 2022, 26(4): 9-13. DOI: 10.7619/jcmp.20214023
Citation: YANG Hong, LAN Ruihong, HONG Yan, SONG Jie, GONG Humin. First-trimester versus second- and third-trimester pregnancy in prenatal ultrasonographic features of placenta accreta[J]. Journal of Clinical Medicine in Practice, 2022, 26(4): 9-13. DOI: 10.7619/jcmp.20214023

First-trimester versus second- and third-trimester pregnancy in prenatal ultrasonographic features of placenta accreta

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  • Received Date: October 12, 2021
  • Available Online: March 21, 2022
  • Published Date: February 27, 2022
  •   Objective  To compare the prenatal ultrasonographic features and prognostic factors of placenta accreta between first-trimester pregnancy and second-, third-trimester pregnancy.
      Methods  The clinical materials of 120 patients with placenta accreta were analyzed retrospectively, including 18 cases in first-trimester pregnancy and 102 cases in second-, third-trimester pregnancy. All the pregnant women were conducted with prenatal ultrasound examination, the efficacy of prenatal ultrasound in diagnosing placenta accreta during different periods of pregnancy was compared, and the ultrasonic characteristics were analyzed. The prognosis of pregnant women was followed up and the related factors of prognosis in pregnant women with placenta accreta were analyzed.
      Results  Compared with pregnant women with placenta accreta in second- and third-trimester pregnancy, the ultrasonic detection rate of placental accreta in the first-trimester pregnancy was lower. The ultrasonic features of placental accreta in the first-trimester pregnancy were mainly the low position of gestational sac, followed by the thinning of anterior wall muscle layer, the low echo area or sound transmission area (lacunae like) in the placenta, and the irregular decidua uterus or placenta uterus interface. The ultrasonic features of placental accreta in the second- and third-trimester pregnancy were mainly the formation of intraplacental vortex, followed by unclear boundary between placenta and uterine myometrium and cervical tissue, rich peripheral blood flow signals, disappearance of retroplacental space and abnormal thickening of placenta. Multivariate analysis showed that the history of cesarean section, postpartum hemorrhage and placenta previa were the risk factors for poor prognosis of pregnant women with placenta accreta, while the anterior wall placenta and the experience of the diagnostician were the protective factors.
      Conclusion  There are great differences in prenatal ultrasonic characteristics of placental accreta between the first-trimester pregnancy and second-, third-trimester pregnancy. The history of cesarean section, placental attachment, postpartum hemorrhage, placenta previa and the experience of the diagnostician are the main factors affecting the prognosis of pregnant women with placental accreta.
  • [1]
    王芊芸, 黄贝尔, 杨慧霞. 胎盘植入发病机制的研究进展[J]. 中华围产医学杂志, 2019, 22(1): 66-69. doi: 10.3760/cma.j.issn.1007-9408.2019.01.014
    [2]
    杨慧霞, 马京梅. 重视胎盘植入的及早诊断及规范化转诊[J]. 中华妇产科杂志, 2019, 54(6): 361-362.
    [3]
    赵扬玉, 种轶文. 超声检查对胎盘植入类型与凶险程度的预测作用[J]. 中华妇产科杂志, 2018, 53(8): 573-576. doi: 10.3760/cma.j.issn.0529-567x.2018.08.013
    [4]
    陈敦金, 杨慧霞. 胎盘植入诊治指南(2015)[J]. 中华产科急救电子杂志, 2016, 5(1): 26-31. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHCJ201601007.htm
    [5]
    杨雁芬, 唐敏敏, 施如勇. 胎盘植入高风险孕妇妊娠早期超声影像特点分析[J]. 中华全科医师杂志, 2019, 18(6): 572-575. doi: 10.3760/cma.j.issn.1671-7368.2019.06.013
    [6]
    潘燕芳, 韦华英. 前置胎盘、胎盘粘连及胎盘植入的临床病理研究[J]. 当代医学, 2018, 24(24): 123-125. doi: 10.3969/j.issn.1009-4393.2018.24.049
    [7]
    曹伟英, 谷宝峰. 产前联合应用二维及彩色多普勒超声对胎盘植入的诊断价值[J]. 医疗装备, 2019, 32(2): 13-14. doi: 10.3969/j.issn.1002-2376.2019.02.009
    [8]
    张君玲, 栗河舟, 李洁, 等. 胎盘植入超声征象: "胎盘陷窝"的再探讨[J]. 中国临床医学影像杂志, 2019, 30(10): 730-733. https://www.cnki.com.cn/Article/CJFDTOTAL-LYYX201910013.htm
    [9]
    马飞, 高小瞻, 王熙, 等. 超声多普勒子宫动脉血流监测诊断前置胎盘植入的研究[J]. 重庆医学, 2019, 48(20): 3595-3597. doi: 10.3969/j.issn.1671-8348.2019.20.042
    [10]
    杨慧霞, 马京梅. 重视胎盘植入的及早诊断及规范化转诊[J]. 中华妇产科杂志, 2019, 54(6): 361-362.
    [11]
    YEOU-LIH W, SHIH-SHIEN W, WEN-CHU H. First-trimester abortion complicated with placenta accreta: A systematic review[J]. Taiwan J Obstet Gynecol, 2019, 58(1): 10-14. doi: 10.1016/j.tjog.2018.11.032
    [12]
    黄泽嫦, 黄苑铭, 黄冬平, 等. 超声在妊娠早期筛查剖宫产后胎盘植入中的应用[J]. 中国医学影像学杂志, 2020, 28(4): 309-312. doi: 10.3969/j.issn.1005-5185.2020.04.018
    [13]
    冯佩明, 王晓岩, 李博, 等. 超声诊断剖宫产瘢痕妊娠与胎盘植入的关系研究[J]. 中国计划生育和妇产科, 2019, 11(9): 64-67, 97. doi: 10.3969/j.issn.1674-4020.2019.09.18
    [14]
    何雪仪, 陈敏霞, 刘国成. 胎盘植入的临床高危因素研究[J]. 广东医学, 2018, 39(z1): 154-155, 158. doi: 10.3969/j.issn.1001-9448.2018.z1.050
    [15]
    苏晓力. 彩色多普勒超声在产前胎盘植入中的诊断效果及对预后的影响观察[J]. 实用妇科内分泌电子杂志, 2019, 6(7): 88-88. https://www.cnki.com.cn/Article/CJFDTOTAL-FKDZ201907060.htm
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