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超声表现及 50 例异位妊娠的临床分析。

Ultrasound manifestations and clinical analysis of 50 cases of heterotopic pregnancy.

机构信息

Department of Ultrasound, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, China.

Department of Gynecology, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, China.

出版信息

J Clin Ultrasound. 2024 Jun;52(5):491-498. doi: 10.1002/jcu.23660. Epub 2024 Mar 4.

Abstract

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%.

CONCLUSION

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.

摘要

目的

探讨超声在异位妊娠诊断及随访中的价值。

方法

回顾性分析我院经临床诊断的 50 例异位妊娠患者的临床资料和超声表现,总结其特征,分析初次超声漏诊和误诊原因,并对妊娠结局进行随访。

结果

50 例患者中,宫内妊娠均为孕囊型,其中 32 例异位妊娠位于输卵管,10 例位于子宫角,1 例位于宫颈,1 例位于剖宫产瘢痕处。与手术和/或病理符合 41 例,初次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%)。宫内妊娠孕囊最大径线 9-48mm,平均约 24.90±9.56mm,异位妊娠孕囊或包块最大径线 11-63mm,平均约 31.45±13.82mm(p<0.05)。随访宫内妊娠结局,完整资料 45 例,失访 5 例,随访率约为 90%。

结论

结合患者病史和临床特征,可减少异位妊娠的漏诊和误诊。超声在评估宫内妊娠的生长发育和子宫完整性方面具有重要价值。

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