目的：探讨彩色多普勒超声对胎盘植入的产前、产后诊断价值。方法回顾性分析手术证实的30例胎盘植入患者的二维声像图及多普勒血流显像特点，观察子宫肌壁厚度、胎盘内部回声、胎盘后方与子宫肌壁间回声，并对胎盘实质内及胎盘后方血流作综合分析。结果30例胎盘植入患者，产前诊断6例，诊断符合率为20%（6/30），漏诊24例，漏诊率为80%（24/30）。前壁胎盘14例，产前检出5例，检出率为35.7%；非前壁胎盘16例，检出1例，检出率6.2%；合并前置胎盘6例，检出4例，检出率为66.7%。结论合并前置胎盘的胎盘植入产前诊断率较高，其他部位诊断率较低；产后胎盘残留声像图明显，结合彩色血流能够明确胎盘植入。%Objective To explore the effectiveness of application of CDU (Color Doppler Ultrasound) in prenatal and postnatal diagnosis of placenta accretas. Methods The two-dimensional sonographic and CDFI (Color Doppler Flow Imaging) manifestations of 30 placenta accreta patients who had been conifrmed by surgery were retrospectively analyzed. Then, the thickness of the uterine muscle wall as well as the echos of the intro-placental and retro-placental regions and the uterine muscle wall was observed;and comprehensive analysis of the blood lfow in the placental parenchyma and retro-placental regions was also made. Results Among 30 cases of placenta accretas, there were 6 cases of prenatal diagnosis for placenta accreta (The Rate of Diagnosis:20%(6/30));24 cases of misdiagnosis (The Rate of Misdiagnosis:80%(24/30)). Moreover, among 14 cases of anterior placentas, 5 cases were prenatally diagnosed (The Detection Rate:35.7%). And among six cases of the anterior placenta complicated with placenta previa, 4 cases were detected (The Detection Rate:66.7%). Conclusion The rate of prenatal diagnosis for the anterior placenta complicated with placenta previa was higher than that for other regions. The residue of postnatal placentas had an obvious sonogram. Combined application of CDFI and CDU can be used for identiifcation of placenta accretas.
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