Lodhi S K, Khanum Z, Watoo T H
Department of Obstetrics and Gynaecology, King Edward Medical College, Lahore.
J Pak Med Assoc. 2004 Feb;54(2):81-3.
To assess the role of ultrasound in detecting the migration of placenta previa during the third trimester at Lady Willingdon Hospital and Jinnah Hospital, Lahore during the period July 2000 to September 2002.
Eighty pregnant women with the diagnosis of placenta previa at 28 to 32 weeks of gestation were included in the study. After base line ultrasound, scan was repeated every two weeks until delivery or placental migration for more than 3 cm from internal cervical os. Detailed information for placental position, distance from cervical os and relation to presenting part was recorded. Women with major degree placenta previa were admitted in the hospital at 32 -34 weeks of gestation. Delivery plan was made according to degree of placenta previa by completed 37 weeks of gestation. Cesarean section was done for the women with major degree placenta previa and minor degree placenta previa with antepartum hemorrhage and obstetric indication
Out of 80 women placental migration to a distance of more than 3-5 cm from the internal cervical os occurred in 20 cases (12 anterior/anterolateral, 8 posterior/posterolateral) by 36 weeks of gestation and 20 had complete placenta previa. Out of remaining 40 cases, 12 patients had vaginal delivery and 28 had cesarean section. Placental migration was not observed in women with total placenta previa or posterior placenta previa when the distance of lower edge of placenta was less than 1 cm from the internal os.
Ultrasound is important for the diagnosis of placental localization and placental migration during third trimester. Placental migration takes place more often in anterior than in complete or posterior placenta previa.
评估2000年7月至2002年9月期间在拉合尔威灵顿夫人医院和真纳医院，超声在孕晚期检测前置胎盘迁移中的作用。
本研究纳入80例妊娠28至32周诊断为前置胎盘的孕妇。在进行基线超声检查后，每两周重复扫描一次，直至分娩或胎盘从宫颈内口迁移超过3厘米。记录胎盘位置、距宫颈内口的距离以及与先露部的关系等详细信息。前置胎盘程度较重的孕妇在妊娠32 - 34周入院。根据妊娠满37周时前置胎盘的程度制定分娩计划。对于前置胎盘程度较重以及有产前出血和产科指征的轻度前置胎盘孕妇行剖宫产。
80例孕妇中，到妊娠36周时，有20例（12例前位/前侧位，8例后位/后侧位）胎盘从宫颈内口迁移至距离超过3 - 5厘米，20例为完全性前置胎盘。其余40例中，12例经阴道分娩，28例行剖宫产。当胎盘下缘距宫颈内口小于1厘米时，完全性前置胎盘或后置胎盘孕妇未观察到胎盘迁移。
超声对于孕晚期胎盘定位和胎盘迁移的诊断很重要。前置胎盘的胎盘迁移比完全性或后置胎盘更常见。
