Assessment Of Color Doppler Sonography In The Diagnosis Of Placenta And Its Impact On The Mother And Son

ObjectivesTo analyze the effect of placental abnormalities on children and their mother andto explore the impact factors of placental abnormalities，to evaluate the reliability ofultrasound in diagnosing placental abnormalities，which can help improve thediagnostic accuracy of ultrasound and provide reference to conduct early clinicalintervention．MethodsBased on the copies of medical records of10023cases who came to the hospitalbecause of pregnancy and did prenatal ultrasound diagnosis at the same time fromJuly2012to July2013，the postnatal placental examination results were regarded asthe gold standard to obtain the type，quantity and constitute ratio of placentalabnormalities． By comparing the results of prenatal ultrasound and postnataloutcome，the ultrasonic diagnostic sensitivity，specificity，the rate of misdiagnosis，misdiagnosis rate were calculated．300mothers were randomly selected from thenormal group as the control group，to analyze the pregnancy outcome and the impactfactors of patients with placental abnormalities．The database was established byExcel,the statistical analysis were performed on SPSS15.0software. Themeasurement data was described with mean±standard deviation（x±s）, two groupswere compared with group T test. Categorical data was described with constituentratio and rate, low detection rate was calculated by Fisher’s exact test(α=0.05).Results（1） Detection of placental abnormalities There were217cases who were ofplacental abnormalities，the detection rate was2.16%（217/10023）; includingplacenta previa， placenta accreta， placenta previa merger implantation， placentalmorphological abnormalities， placental abruption，etc，among which106cases were abnormal placental shape，and its ratio was up to48.8%， which was the highestamong all the placental abnormalities．（2） Results of ultrasound The overall rate of prenatal ultrasound indiagnosing placental abnormalities was99.73%， and prenatal ultrasound had asensitivity of88.94%， a specificity of99.97%，a missed diagnosis rate of11.06%and a misdiagnosis rate of0.03%; the sensitivity，specificity，rate of misdiagnosis，misdiagnosis rate and compliance rate varied acoding to different types， in whichsimple placenta accreta had the highest missing rate（69.23%）; placental hemangiomahad the highest sensitivity（100.00%）．（3） Effects of abnormal placenta on women The percentage of prepartumhemorrhage proportion was22.6%in all217cases of placental abnormalities， theproportion of cesarean section62.2%，the postpartum hemorrhage proportion64.5%，and hysterectomies proportion3.2%，compared with the control group， they werehigher， the difference were statistically significant （P<0.05）．And the above fourindicators varied among different types of placental abnormalities（P<0.05）．（4） Effects of abnormal placenta on children There were232newbornsof217cases of placental abnormalities， with a length of49.9±3.5cm， a weight of(2863.7±434.1)g，and an apgar score（7.6±2.1），compared with the control group,they were lower, the difference was statistically significance （P<0.05）． There werefive preterm cases and three deformity cases， and compared with the control group，there were no significant difference（P>0.05）．Height，weight and Apgar scoredifferences between the different types of placental abnormalities were notstatistically significant （P>0.05）．（5） Impact factors for abnormal placental Compared with the controlgroup， age， reproductive history， history of abortion， history of cesarean sectionand uterine malformations and other aspects were different between the two group，there were statistically significant （P<0.05）; Compared with the control group,influencing factors of different types of abnormal placenta were higher than controlgroup, the difference was statistically significant (P<0.05). Conclusions1．Ultrasound had a high sensitivity and specificity in diagnosing placentalabnormalities．2． Pregnancy women who were older or had reproduction， abortion， historyof cesarean section or uterine malformations should be given more concern whenultrasonography being used for screening．3． Among all cases of placenta placental abnormalities， morphologicalabnormalities were the most common，which was followed by placenta previa，placental abruption，placenta accreta．4．Placental abnormalities have adverse effects on mother and child：neonatallength，weight，Apgar scores were lower; prenatal maternal hemorrhage，postpartumhemorrhage，cesarean section，hysterectomy，the proportion was higher．...