Haino Kazufumi, Ishii Keisuke, Kanda Masako, Kanai Asako, Hayashi Shusaku, Mitsuda Nobuaki
Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan.
Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.
J Med Ultrason (2001). 2018 Jan;45(1):99-102. doi: 10.1007/s10396-017-0791-8. Epub 2017 Apr 27.
This study aimed to investigate the impact of placental migration on the definitive prepartum diagnosis of patients with placenta previa (PP) and low-lying placenta (LLP) after late preterm.
This was a retrospective cohort study of singleton pregnancies with PP and LLP diagnosed at 30-33 weeks of gestation. We assessed the rate of changes in transvaginal ultrasonographic measurements of placental position during the period from 34 to 38 weeks of gestation.
A total of 127 cases (82 of PP, 45 of LLP) were included. The PP group comprised 34 cases with complete PP and 48 with partial and marginal PP. The diagnosis of complete PP was changed to partial or marginal PP in two (5.9%) cases. Concerning cases with partial and marginal PP, 14 (29.2%) were eventually revised to LLP and four (8.3%) ultimately normalized. Among the patients with LLP, placental position was normalized in 23 (51.1%). Overall, a revision in diagnosis after late preterm was required in 48 cases (37.8%). Among the 93 patients who did not have complete PP, 46 (49.5%) needed revisions of their placental diagnosis.
Repeated evaluations of placental position by ultrasonography after late preterm could be of significant value in selecting the most appropriate mode of delivery.
本研究旨在探讨胎盘迁移对晚期早产后置入胎盘（PP）和低置胎盘（LLP）患者产前最终诊断的影响。
这是一项对妊娠30 - 33周诊断为PP和LLP的单胎妊娠进行的回顾性队列研究。我们评估了妊娠34至38周期间经阴道超声测量胎盘位置的变化率。
共纳入127例病例（PP 82例，LLP 45例）。PP组包括34例完全性PP和48例部分性及边缘性PP。2例（5.9%）完全性PP的诊断改为部分性或边缘性PP。在部分性和边缘性PP病例中，14例（29.2%）最终改为LLP，4例（8.3%）最终恢复正常。在LLP患者中，23例（51.1%）胎盘位置恢复正常。总体而言，48例（37.8%）晚期早产后置入胎盘诊断需要修订。在93例非完全性PP患者中，46例（49.5%）需要修订胎盘诊断。
晚期早产后置入胎盘后通过超声反复评估胎盘位置对选择最合适的分娩方式可能具有重要价值。
