前置胎盘期待疗法剖宫产时机的探讨

Timing of cesarean section in expectant treatment of placenta previa

目的探讨前置胎盘期待治疗法剖宫产时机的选择,提高围产儿生存率。方法对4年来收治的153例前置胎盘期待疗法剖宫产终止妊娠患者,按孕周、剖宫产时机急诊或择期剖宫产随机分组进行统计分析,探讨剖宫产时机与提高围产儿生存率的关系。结果孕周34周以上患者择期剖宫产围产儿生存率明显高于急诊剖宫产者差异有显著性(P<0.01)。结论前置胎盘孕周达34周以上者,期待疗法不再进行,择期剖宫产终止妊娠,既提高了围产儿生存率,又避免了母儿因病情恶化出现严重并发症。

[Objective] To evaluate how to choose the time of cesarean section in the expectant treatment of placenta previa and improve the perinatal surrival. [Methods] One hundred and fifty-three pregnant women suffered from placenta previa with cesarean section in the expectant treatment and devided into groups of gestitional age and the time of cesarean section with the rugent cesarean and reasonable time of operation, were enrolled for study for four years. [Results] The perinatal surrival of choosing cesarean section with gestintional age above thirty-four weeks in placenta previa patients were significant larger than urgent operation patients （P 〈0.01）. [Conclusions] The patient of placenta previa above thirty-four weeks then there is no need improving expectant treatment, choosing reasonable cesarean section not improved the perinatal surrival but avoided severe complications on account of signs of worsening maternal and fetal condition.