Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan.
Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan.
Taiwan J Obstet Gynecol. 2022 Jul;61(4):713-716. doi: 10.1016/j.tjog.2021.08.007.
To demonstrate ultrasound pathological findings of placental abruption (PA) detected using a new Doppler method: superb microvascular imaging (SMI).
The patient was a pregnant woman with dark brown vaginal discharge at 32 + 4 weeks of gestation. Conventional ultrasound revealed an exophytic heterogeneous area measuring 3 cm, between the placenta and myometrium. SMI showed no minor blood flow inside the area. A diagnosis of marginal sub-chorionic hematoma was made. On the seventh day of hospitalization, SMI showed pulsation of blood flow in the inter-villous space and fetal blood flow in the villous trees. Due to an increase in the frequency of uterine contractions, an emergency cesarean section was performed. Histopathological examination showed hematomas beneath the decidual tissue, and the decidual layer was undamaged. The inter-villous space was preserved.
SMI can contribute to a more accurate PA diagnosis that may lead to timely administration of obstetric intervention.
展示使用新的多普勒方法——超级微血管成像(SMI)检测到的胎盘早剥(PA)的超声病理发现。
患者为妊娠 32+4 周的孕妇,出现深褐色阴道分泌物。常规超声显示胎盘和子宫肌层之间有一个 3 厘米的外生性异质性区域。SMI 显示该区域内无小血流。诊断为边缘性胎盘下血肿。住院第 7 天,SMI 显示绒毛树中绒毛间空间和胎儿血流的搏动。由于子宫收缩频率增加,行紧急剖宫产术。组织病理学检查显示在蜕膜组织下有血肿,蜕膜层未受损。绒毛间空间得以保留。
SMI 有助于更准确地诊断 PA,可能会及时进行产科干预。