目的探讨产前超声检查诊断前置胎盘植入的应用价值。方法选取2009年3月—2016年6月湖州市妇幼保健院产科行剖宫产分娩的87例前置胎盘孕妇作为研究对象,所有对象产前均接受常规二维超声及彩色多普勒超声检查,根据术后病理结果分为胎盘植入组、胎盘非植入组,对比2组患者的超声声像特征,并计算产前超声诊断胎盘植入的灵敏度、特异度、漏诊率、误诊率、Kappa值。结果 87例前置胎盘患者,前置胎盘植入组的胎盘增厚、胎盘后部间隙全部或部分消失、胎盘附着处子宫肌层厚度、胎盘内部回声不均匀、胎盘附着处子宫浆膜层-膀胱交界面血管丰富、局灶性或广泛性胎盘实质内腔隙血流的发生率均显著高于非胎盘植入组,差异具有统计学意义(P<0.05);胎盘植入和非胎盘植入组的前置胎盘类型差异不具有统计学意义(P>0.05);以病理学结果作为金标准,产前超声诊断前置胎盘植入的灵敏度为80.00%、特异度为91.23%、漏诊率为20.00%、误诊率为8.77%,Kappa值为0.718。结论产前超声检查诊断前置胎盘植入具有较高的灵敏度与特异度,可为安全分娩提供指导。 Objective To investigate the value of prenatal ultrasound in the diagnosis of placenta accreta. Methods From March 2009 to June 2016, 87 cases of placenta previa delivered by cesarean section in obstetrics and gynecology department of Huzhou Maternal and Child Health Hospital were enrolled in this study. All subjects received conventional two-dimensional ultrasound and color Doppler ultrasonography , According to the postoperative pathological results were divided into placenta accreta, placenta non-implanted group, compared the two groups of patients with ultrasonographic features and prenatal ultrasound diagnosis of placenta accreta sensitivity, specificity, misdiagnosis rate, misdiagnosis rate, Kappa value. Results 87 cases of placenta previa, placenta previa placenta accreta thickening of the placenta, the rear part of the gap completely or partially disappeared, the thickness of the myometrial placenta attached to the placenta internal echo uneven, the placenta attached to the serosa - The incidence of vessel-rich interface and focal or extensive intraparenchymal lacunar flow were significantly higher in non-placenta group than in non-placenta group (P <0.05). Placenta accreta and non-placenta accreta There was no significant difference in the type of placenta previa between the two groups (P> 0.05). The sensitivity of prenatal ultrasound for placenta accreta was 80.00% and the specificity was 91.23%. The misdiagnosis rate Was 20.00%, misdiagnosis rate was 8.77%, Kappa value was 0.718. Conclusion Prenatal ultrasound diagnosis of placenta accreta has a high sensitivity and specificity, can provide guidance for safe labor.