摘要
目的探讨超声对先兆流产合并绒毛膜下血肿妊娠结局的预测价值。方法416例有先兆流产症状的早孕期孕妇,经超声检查发现绒毛膜下血肿,且胚胎存活;按面积比例法分为轻、中、重三种程度,依据初次阴道流血时间将孕妇分为≤8周和>8周。分析不同程度的绒毛膜下血肿和不同的阴道流血时间条件下,患者20孕周前发生自然流产的情况。结果总的自然流产率是12.3%(51/416),轻度、中度和重度绒毛膜下血肿的自然流产率分别是8.6%、11%和41%(21/242、15/136和15/38);轻、中度血肿患者的自然流产率差异无显著性意义(P>0.05),而重度血肿患者的流产发生率与轻度和中度血肿比较,差异均有显著性意义(χ2分别为27.8,16.8,均P<0.05);初次阴道出血时孕周≤8周和>8周的患者自然流产率差异无显著性意义(P>0.05)。结论对于超声发现有绒毛膜下血肿的早孕期孕妇,评估血肿大小程度,对预测妊娠结局有重要的参考价值。
Objective To explore the predictive value of subchorionic hematoma detecting by ultrasound on the pregnant outcome in patients with vaginal bleeding in the first trimester of pregnancy. Methods a retrospective review was performed with ultrasound images obtained in 416 patients with vaginal bleeding, alive fetus, and a subchorionic hematoma in the first trimester. Hematoma size was graded aceording to the percentage of the chorionic sac area elevated by the hematoma. Patients were also classified as equal to or less than 8 weeks and more than 8 weeks according to gestational age. The effect of these two factors on the pregnant outcome were analysed. Results The overall spontaneous abortion rate was 12. 3% {51/416 ） , the abortion rate were 8. 6% and 11% （21/242 and 15/136） in the small and medium-sized subchorionic hematoma respectively; the large hematoma was found to associated with 4. 7 and 3.7 times increase of spantanous abortion rate. There was significant difference （ P 〈 0. 05 ） The spontaneous abortion rate was approximately twice as high for women which bleeding at 8 weeks gestation or less compared with those bleeding at greater than 8 weeks gestation. Conclusion Subchorionic hematoma deteceted and evaluated by ultrasound has important predictive value in patients with vaginal bleeding in the first trimester of pregnancy.
出处
《实用医院临床杂志》
2009年第5期58-60,共3页
Practical Journal of Clinical Medicine
关键词
超声
绒毛膜下血肿
阴道出血
自然流产
Ultrasound examination
Subchorionic hemorrhage
Vaginal bleeding
Spontaneous abortion
