Study On Blood Supply Of Placenta By Three-dimensional Energy Doppler

purpose:Three-dimensional energy Doppler ultrasound technology and virtual tissue computer-aided analysis system are used to quantitatively analyze the three-dimensional energy Doppler index of the placenta(ie,vascularization index VI,blood flow index FI,vascularization-blood flow index VFI).Analyze the relationship between VI,FI,VFI of normal placenta in pregnancy and the gestational age and neonatal weight;compare the differences between VI,FI,VFI of normal placenta in pregnancy and placenta of hypertensive disease in pregnancy,and observe the changes impact on neonatal weight;analyze of the difference between the VI,FI,VFI of the placenta previa and the placenta implanted with the pedigree disease placental disease and the amount of bleeding during cesarean section;Analyze the relationship between VI,FI,VFI of PAS placenta and the amount of bleeding during cesarean section.method:Select the placenta of 80 normal pregnant women from 33 to 40 weeks of gestation,80 placentas with HDCP only,123 placenta previa or placenta of pregnant women with PAS without other diseases and apply 3D-PDU to obtaining the area of interest Placenta tissue from the mother surface to the child surface of the placenta.After obtaining the three-dimensional energy map,analyze it with VOCAL software to calculate the three-dimensional energy Doppler index of the placenta,that is,the vascularization index(VI): Indicates the degree of blood vessel thinning and blood flow index(,FI): Represents the average intensity of blood flow signal,vascularization-blood flow index(VFI): Represents the sum of blood vessel and blood flow information.Follow-up pregnancy outcomes and record neonatal weight,intraoperative findings,placental pathological results,and calculate intraoperative blood loss.SPSS25.0 statistical software is used for statistical analysis of the results.result:1.The relationship between VI,FI and VFI of placenta in normal group and gestational age and neonatal weight.In the normal group of this study,there are 80 cases of placenta data,and there are no abnormalities in the surgical and pathological results after delivery.The VI and VFI of the placenta in the normal group are correlated with gestational age and neonatal weight.The equation expression is: VI = 0.417GA~2-26.499GA+441.563(r= 0.765,P <0.01),VFI = 0.26GA~2--16.858 GA + 283.349(r=0.791,P<0.01),neonatal weight(g)=-1.324VI~2 + 149.628VI-172.313(r = 0.903,P <0.01),neonatal weight(g)=-4.988VFI~2 + 277.678 VFI + 157.466(r = 0.886,P <0.01).The P values of VI and VFI are both less than 0.01,which is statistically significant.VI and VFI are highly correlated with gestational age and neonatal weight.VI and VFI are curve-related.The equation expression is: VI = 0.07VFI~2 + 1.673 VFI + 4.281(r = 0.983,P <0.01).P value is less than 0.01,so the two are highly correlated.There is no significant correlation between FI and VI,VFI,gestational age,and neonatal weight.2.The relationship between placental VI and VFI in HDCP group and neonatal weight.The placenta VI and VFI in the HDCP group show a curvilinear relationship with the neonatal weight.The equation expression is: neonatal weight(g)=-0.478VI~2 + 65.67 VI + 944.139(r = 0.439,P <0.01),neonatal weight(g)=-2.393VFI~2 + 136.276 VFI + 1018.464(r = 0.462,P < 0.01).Through the study,we find that the correlation between VI,FI and placental weight of the placenta in the HDCP group is lower than that in the normal group.3.Comparison of VI,FI,VFI and neonatal weight of placenta in normal group and HDCP group.There are significant differences in VI,FI,VFI,and neonatal weight between the two groups of pregnant women(P <0.01).4.Comparison of VI,FI,VFI and intraoperative blood loss in placenta previa group and PAS group placenta.In this study,a total of 123 placenta previas are divided into simple placenta previa group(23 cases)and PAS group(100 cases)according to intraoperative findings and pathological results.There are statistically significant differences in placenta VI,VFI,and intraoperative blood loss between the two groups of pregnant women(P <0.01).There is no statistically significant difference in FI between the two groups of pregnant women's placenta(P> 0.05).5.The relationship between VI,FI,VFI of placenta in PAS group and the amount of bleeding during cesarean section.The study finds that VI,VFI of placenta shows a curvilinear relationship with intraoperative blood loss during cesarean section.The equations are: intraoperative blood loss(ml)= 1.44 VI~2 + 9.191 VI + 507.744(r = 0.942,P <0.01),intraoperative blood loss Amount(ml)= 6.945 VFI~2 + 23.904 VFI + 509.394(r = 0.897,P <0.01).The P values of placenta VI and VFI are both less than 0.01,which is statistically significant.It shows that VI,VFIof placenta have significant correlation with intraoperative blood loss,while FI has no significant correlation with intraoperative blood loss.in conclusion:1.The regression equation is used to find the relationship between the VI and VFI of the placenta during normal pregnancy and the gestational age and neonatal weight.2.The VI,FI,and VFI of the placenta in the HDCP group are significantly lower than those in the normal group,indicating that the blood perfusion of the placenta in the pregnant women with HDCP is significantly insufficient,and it is unable to provide sufficient nutrients for the fetus.3.Use the regression equation to find the relationship between the VI and VFI of the PAS placenta with and the amount of bleeding during cesarean section.The amount of bleeding during the operation can be evaluated before surgery,so that the clinician can have more adequate preoperative preparation.