帆状脐带入口的产前超声检查与诊断

doi:10.3877/cma.j.issn.1673-5250.2013.04.002

图1 帆状脐带入口(孕妇：23岁，孕龄为23孕周，合并严重法洛四联症而引产)[A：产前超声CDFI检查见脐带入口位于前壁胎盘下段胎膜下(白色箭头所示)，脐带血管走行一段距离后进入胎盘；B ：PW检查示频率为149次/min，与胎心率一致；C：引产后胎盘标本证实为帆状脐带入口(黑色箭头所示)]

Figure 1 Velamentous umbilical cord insertion (23-year-old woman, 23 weeks gestation. The fetus was teminated as complicated with severe tetralogy of Fallot)[A: The umbilical cord insertion was found by prenatal ultrasound on the anterior wall under the amniotic membrane below the placenta (showed by white arrow). The umbilical vessels attained the placenta by coming under the amniotic membrane; B: The rate of the vessel under the amniotic membrane was 149 beat/min by PW, which was similar the the heart rate of the fetus；C: Specimens of the placenta confirmed velamentous umbilical cord insertion(showed by black arrow)]

图2 帆状脐带入口(孕妇：23岁，孕龄为24孕周)[A：产前二维超声检查示脐带入口(白色箭头所示)位于后壁胎盘上的胎膜下，脐带血管呈平行条状无回声走行于胎膜下后进入胎盘，脐带血管管壁薄，未见脐带螺旋。B ：彩色多普勒血流显像检查示胎膜下条状无回声内见血流信号(箭头所示)，红色血流信号为脐动脉，蓝色血流信号为脐静脉]

Figure 2 Velamentous umbilical cord insertion (23-year-old woman, at 24 weeks gestation) [A: The umbilical cord insertion was on the posterior wall under the amniotic membrane on two dimensional ultrasound (showed by white arrow). The umbilical vessels ，which were thin-wall and lacked umbilical coil, went parallelly and staightly under the amniotic membrane to the placenta; B: Blood flow signals were found on the vessels under the amniotic membrane by color Doppler flow imaging(showed by arrow). Red signal indicated umbilical artery, while blue signal indicated umbilical vein]

图3 帆状脐带入口(孕妇：33岁，孕龄为22孕周)[产前超声彩色多普勒血流显像检查胎盘脐带入口位于前壁胎膜下(箭头所示)，脐带血管向上走行于胎膜下一段距离进入宫底部胎盘]

Figure 3 Velamentous umbilical cord insertion (33-year-old woman, at 22 weeks gestation) [The umbilical cord insertion was on the anterior wall under the amniotic membrane (showed by white arrow) by prenatal ultrasound by using color Doppler flow imaging. The umbilical vessels went upward under the amniotic membrane to the placenta which was on the fundus]

图4 帆状脐带入口(孕妇：28岁，孕龄为24孕周)[A：产前二维超声检查示脐带入口位于前壁下段胎膜下(箭头所示)，脐带血管走行于胎膜下平直走向前壁胎盘；B : 彩色多普勒血流显像检查更清楚显示胎膜下脐带入口(箭头所示)；C: PW检查示胎膜下血管频率为144次/min，与胎心率一致，为脐带血管]

Figure 4 Velamentous umbilical cord insertion (28-year-old woman, at 24 weeks gestation) [A: The umbilical cord insertion was on the low section of the anterior wall under the amniotic membrane on two dimensional ultrasound(showed by white arrow). The umbilical vessels went straightly under the amniotic membrane to the anterior placenta; B: The umbilical cord insertion was found clearly by color Doppler flow imaging (showed by white arrow); C: The rate of the vessel under the amniotic memberane was 144 beat/min by PW, which was similar the the heart rate of the fetus]

图5 帆状脐带入口并血管前置(孕妇：30岁，孕龄为24孕周)[产前超声检查宫颈管矢状切面示脐带入口(大箭头所示)位于宫颈内口稍上方，脐血管走行于宫颈内口上方胎膜下再走行后壁胎盘]

Figure 5 Velamentous umbilical cord insertion (30-year-old woman, at 24 weeks gestation) [The umbilical cord insertion was on the cervical OS under the amniotic membrane on the sagittal section of the cervix by prenatal ultrasound (showed by big arrow). The umbilical vessel went under the amniotic membrane to the posterior placenta]

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