Ultrasound detection of uterine arcuate artery and umbilical artery blood flow in the diagnosis of placenta previa with accreta / 中国基层医药

ABSTRACT

Objective:To investigate the clinical value of ultrasound detection of uterine arcuate artery and umbilical artery blood flow parameters measured by ultrasound imaging during the second trimester of pregnancy in the diagnosis of placenta previa with accreta.Methods:Eighty patients with placenta previa with accreta who received regular prenatal examination and terminated pregnancy from May 2017 to May 2019 in Zhuji People's Hospital and 80 healthy pregnant women were included in this study. Uterine arcuate artery and umbilical artery blood flow parameters pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV), umbilical artery blood flow PI and RI, ratio of peak systolic to diastolic flow velocity (S/D) were measured by color Doppler ultrasound. Uterine arcuate artery and umbilical artery blood flow parameters were correlated with the occurrence of placenta previa with accreta.Results:Uterine arcuate artery PI and RI in patients with placenta previa with accreta were (0.45 ± 0.12) and (0.38 ± 0.08), which were significantly lower than (0.59 ± 0.17) and (0.46 ± 0.11) in healthy pregnant women. In patients with placenta previa with accreta, uterine arcuate artery PVS and umbilical artery blood flow parameters PI, RI, and S/D were (45.13 ± 4.62), (1.16 ± 0.27), (0.73 ± 0.22) and (3.32 ± 0.31), respectively, which were significantly higher than those in healthy pregnant women [(34.27 ± 3.82), (0.79 ± 0.21), (0.52 ± 0.13) and (2.71 ± 0.24), t = 3.057-9.241, all P < 0.01]. The proportion of placenta previa with previa patients exhibiting abundant and chaotic blood flow signals was significantly higher than that in healthy pregnant women [91.25% (73/80) vs. 86.25% (69/80), χ2 = 96.341, P < 0.01]. Uterine arcuate artery blood flow parameters PI and RI were negatively correlated with the occurrence of placenta previa with previa ( r = - 0.742, - 0.716, both P < 0.05). Uterine arcuate artery blood parameter PVS and umbilical artery blood flow parameters PI, RI and S/D were positively correlated with the occurrence of placenta previa with previa ( r = 0.759-0.885, all P < 0.01). Conclusion:Ultrasound detection of uterine arcuate artery and umbilical artery blood flow parameters and monitoring blood flow changes in pregnant women have a great value in the diagnosis of placenta previa with accreta, which needs more attention in the gynecological clinic.