Obstetric and Gynecologic Ultrasound
The prenatal ultrasonic diagnosis of pernicious placenta previa disease complex with placenta implantation
Qin Li, Xuedong Deng, Zhongyang Wang, Bing Lu, Lili Zhang, Jianqiu Shen, Min Bian
Published 2016-03-01
Cite as Chin J Med Ultrasound(Electronic Edition), 2016, 13(3): 218-223. DOI: 10.3877/cma.j.issn.1672-6448.2016.03.011
Abstract
ObjectiveTo summarize the characteristics of pernicious placenta previa (PPP) disease complex with placenta implantation, and analyze the reason of ultraound misdiagnosis and missed diagnosis in placenta implantation proved by surgical pathology and clinically follow-up.
MethodsFifty-one cases clinically diagnosed PPP disease patients were examined by both transabdominal and transperineal ultrasounography.
ResultsOut of 51 PPP patients, 42 cases (82.4%, 42/51) were proved as placenta increta disease and 9 cases were confirmed with no placenta implantation complication. By transabdominal ultrasound (TAS) combined transperineal ultrasound (TPS) method: 40 cases were correctly diagnosed with placenta implantation (78.4%, 40/51), while 7 cases (13.3%, 7/51) were confirmed without placenta increta, 2 cases (3.9%, 2/51) were mis-diagnosed, 2 cases (3.9%, 2/51) were missed diagnosed. The goup of abdominal ultrasound findings: the placental thickening, diffuse or focal placenta essence lacuna in 25 cases, the gap disappeared after the placenta and placental uterine muscle layer becomes thin (less than or equal to 2 mm) 44 cases, uterine flesh layer arcuate artery arranged in disorder in 34 cases, placental uterine serosa layer bladder junction rich in blood vessels at 18 cases of disorder. Perineal sonography of performance: swelling of lower uterine segment lung, placenta thickening in 25 cases, cervical enlargement, placenta local to the cervical extends into the 6 cases, lower uterine segment and cervical tube placenta cover flow was rich in 8 cases.
ConclusionsPPP disease complex with placenta implantation can be prenatally diagnosed by characteristic ultrasonic features. The combination of TAS and TPS can further improve the diagnostic accuracy of PPP.
Key words:
Ultrasonography, prenatal; Pacenta previa; Placenta implantation
Contributor Information
Qin Li
Center of Medical Ultrasound, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, China
Xuedong Deng
Center of Medical Ultrasound, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, China
Zhongyang Wang
Department of Ultrasound, Taizhou People′s Hospital, Taizhou 225300, China
Bing Lu
Center of Medical Ultrasound, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, China
Lili Zhang
Center of Medical Ultrasound, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, China
Jianqiu Shen
Department of Ultrasound, Taizhou People′s Hospital, Taizhou 225300, China
Min Bian
Department of Ultrasound, Taizhou People′s Hospital, Taizhou 225300, China