ABSTRACT
Objective: To investigate the ultrasonic features of placental abruption (PA) and its outcomes of pregnancy. Methods: Prenatal ultrasonic data of 132 pregnant women diagnosed as PA after delivery were collected, and the ultrasonic findings and pregnancy complications were analyzed. Results: PA was detected with ultrasonography in 48 patients while misses in 84 patients, the detection rate was 36.36% (48/132), and the missed diagnosis rate was 63.64% (84/132). Ultrasound showed placental thickening in 29 cases, intraplacental abnormal echo in 16, retroplacental abnormal echo in 9, placental marginal abnormal echo in 6, abnormal echo at placental fetal surface in 4, abnormal echo between uterine wall and amniotic membrane in 2, abnormal echo in amniotic cavity in 7 cases. The main complications of PA included cesarean section, uterine placental stroke, disseminated intravascular coagulation, postpartum hemorrhage, premature birth, severe neonatal asphyxia and even perinatal death. The incidences of complications in pregnant women with PA detected with ultrasound were higher than those in pregnant women with PA missed with ultrasound (all P<0.05). Conclusion: Prenatal ultrasonic detection rate of PA is low, and the pregnancy outcomes of pregnant women with PA detected with ultrasound is relatively poor.
ABSTRACT
We reported a case of monochorionic monoamniotic twins discordant for anencephaly diagnosed by second-trimester ultrasonography at the First Affiliated Hospital of Fujian Medical University.Ultrasound at seven weeks of gestation showed only one gestational sac with an embryo inside.Another 12 gestational weeks' ultrasound scan performed at another hospital found one gestational sac and one fetus (crown-rump length was 6.11 cm and nuchal translucency was 0.11 cm) in the upper-middle uterine cavity.The ultrasound examination at 22+6 gestational weeks identified one placenta and two fetuses without obvious diaphragm echo in between.Although no structural abnormality was observed in one fetus,frog-like eyes,absence of skull image and brain tissue echo were presented in the other fetus.The patient was transferred to a higher level hospital and was successfully performed radiofrequency ablation for selective reduction at 23+4 weeks of gestation.At 35 weeks,a premature live boy and an anencephalic stillbirth fetus were born vaginally after premature rupture of membranes.The baby boy was healthy at follow-up at four months old.