前置胎盘106例并胎盘植入者7例临床分析

Analysis of 106 cases of placenta previa and 7 case of placenta accrete

目的:探讨前置胎盘及胎盘植入的临床特征及处理方法。方法:对我院2002年1月至2007年1月收治前置胎盘106例的临床资料进行回顾性分析。结果:住院分娩产妇11320例中,前置胎盘106例,发生率为0.9%,其中合并胎盘植入的7例均属中央型(均有宫腔操作史),占前置胎盘总数的6.6%。中央性前置胎盘26例,部分性29例,边缘性51例,分别占24.5%、27.4%、49.1%。行剖宫产术88例(83.0%),阴道分娩18例(17.0%)。7例胎盘植入中行子宫次全切除3例,保守治疗4例。孕产妇死亡率为0,新生儿窒息21例(19.8%),新生儿存活率100%。结论:随着前置胎盘及胎盘植入发病率的增加,选择合适的处理方法尤为重要。积极期待疗法加适时的手术处理,将有助于降低母婴死亡率和发病率。前置胎盘与胎盘植入有相关关系,中央性前置胎盘为胎盘植入的高危因素。

Objective： To analyzethe risk factors of placenta previa and placenta accrete, and the matema newborn outcome. Methods： Retrospectivestudy of placenta previa（ 106 cases） and placenta accrete （7 cases） performed. Hospital records January 2002 and January 2007 were analyzed. Results： Among 11 320 partuients, one hundred and six cases （0.9 %） had placenta previa, and seven （6.6%） of them had placenta ccreta. 93 cases （87.7 %） had a history of previous uterinesurgical manipulation. Out of the 106 cases of placentprevia, 26 cases （24.5 %） were complete placenta previa, 29 cases （27.4%） were partial and 51 cases were （49.1%） marginal. Ninetysix women （83.0%）underwent cesarean section. All seven cases of placenta accreta came from complete placenta previa, three of them underwent subtotal hysterectomy, four of them succeeded after conservativ management and treatment. There was no maternal newborn matahty. Newborn asphyxia rate was 19.8 %. Survival rate for the newborn was 100%. Conclusion： With the increasing incidence of placenta previa and placentaccreta, selection of an appropriate method is important. Appropriate patient management and surgical technique ma reduce mortality and morbidity related to this condition. The placenta had relative relationship with its embed especially in central type.