目的:探讨超声对异位妊娠的诊断及随访价值。
方法:回顾性分析我院临床诊断为异位妊娠的50例,总结了患者的临床特点和超声表现,初步分析超声漏诊和误诊的原因,并对妊娠结局进行了随访。
结果:在50例中,超声初步诊断宫内妊娠均为孕囊型,32例异位妊娠均位于输卵管,10例位于子宫角,子宫颈1例,剖宫产瘢痕1例。41例符合手术和/或病理,代表初始超声诊断符合率约为82%。初次超声检查漏诊6例(12%),误诊3例(6%)。宫内孕囊的最大直径为9-48mm,平均值约为24.90±9.56毫米,异位妊娠孕囊或包块的最大直径为11-63毫米,平均值约为31.45±13.82mm(p<0.05)。随访宫内妊娠结局,45例数据完整的患者和5例患者失访。随访率约为90%。
结论:结合患者病史和临床特点可减少异位妊娠的漏诊和误诊。超声检查对评价宫内妊娠生长发育有重要价值,和母体子宫的完整性。
OBJECTIVE: To investigate the value of ultrasonography in the diagnosis of heterotopic pregnancy and the follow-up.
METHODS: A retrospective analysis of 50 cases of clinically diagnosed heterotopic pregnancy in our hospital was performed, the clinical characteristics and ultrasonographic manifestations of the patients were summarized, the reasons for initial ultrasound missed diagnosis and misdiagnosis were analyzed, and the pregnancy outcomes were followed up.
RESULTS: Among the 50 cases, the initial ultrasound diagnoses of intrauterine pregnancy were all gestational sac type, 32 cases of ectopic pregnancy were located in the fallopian tube, and 10 cases were located in the uterine horn, 1 case at cervix, and 1 case at caesarean section scar. Forty-one cases were consistent with surgery and/or pathology, representing initial ultrasound diagnosis coincidence rate of about 82%. Six cases were missed in the initial ultrasound examination (12%), and three cases were misdiagnosed (6%). The maximum diameter of the intrauterine gestational sac was 9-48 mm, the average was about 24.90 ± 9.56 mm, the maximum diameter of the ectopic pregnancy gestational sac or mass was 11-63 mm, and the average was about 31.45 ± 13.82 mm (p < 0.05). Intrauterine pregnancy outcomes were followed up, 45 patients with complete data and 5 patients were lost to follow-up. The follow-up rate was about 90%.
CONCLUSIONS: Combining the patient\'s medical history and clinical characteristics can reduce missed diagnosis and misdiagnosis of heterotopic pregnancy. Ultrasonography has important value in the assessment of intrauterine pregnancy growth and development, and the integrity of maternal uterus.