前置胎盘与妊娠结局的临床分析

Clinical Analysis of Placenta Praevia and Pregnancy Outcome

目的探讨前置胎盘病因、类型、临床表现与妊娠结局。方法将142例前置胎盘患者设为前置组,并分为完全组(72例)、部分组(29例)、边缘组(41例);同时随机选择正常妊娠孕妇142例,进行回顾性分析。结果高龄、经产、流产、剖宫产为发生前置胎盘的高危因素;三组前置胎盘患者产前出血、产后出血、输血、诊断孕周、分娩孕周、阴道分娩、早产、新生儿体质量及窒息比较,差异均有显著性意义(P<0.05或P<0.01);三组前置胎盘患者失血性休克、子宫切除、急诊剖宫产、择期剖宫产、小于胎龄儿及围产儿死亡比较,差异均无显著性意义(P>0.05)。结论妊娠结局与前置胎盘的类型有关,完全性及部分性前置胎盘临床症状较重,母儿预后较差。

Objective To investigate placenta praevia about its etiology,type,clinical manifestation and pregnancy outcome . Methods Retrospective analysis was carried out amonyg patients with pregnantee. 142 eases was patients with normal pregnancy, 142 cases was patients with placenta praevia, which was then divided into three groups ： central group （ 72 eases） , partial group （ 29 cases ） and marginal group （41 eases ）. Results Eld, muhiparity, miscarriage and uterine-incision delivery were high risk factors of placenta praevia. The difference has statistical significance among three groups with placenta praevia in many indexes,in- eluding antepartum hemorrhage, postpartum hemorrhage, blood transfusion, diagnosis of gestational weeks, childbearing of gestational weeks, vaginal delivery, premature birth, neonate body weight, and asphyxia. （ P 〈0. 05 or P 〈0. 01 ）. While the difference has no statistical significance among three groups in some indexes, including hemorrhagic shock, uterectomy, uterine-incision delivery in emergency state, elective caesarean section ,death of small for gestational age infant and neonate （ P 〉 0. 05 ）. Conclusion Pregnancy outcome is related to the type of placenta pracvia. Central and partial placenta praevia have severe clinical symptom, mothers and children have poor prognosis.