胎盘植入相关因素及妊娠结局的分析

Study on related factors and pregnancy outcome for placenta accreta

目的分析胎盘植入的相关因素及妊娠结局。方法对2002年1月至2012年6月间收治的28例胎盘植入患者与非胎盘植入者的年龄、分娩次数、人流次数、剖宫产史、合并前置胎盘、产后出血、子宫切除及早产儿发生率等指标进行回顾性分析。结果胎盘植入的高危因素包括:孕妇年龄≥35岁、分娩次数≥2次、人流次数≥2次、有剖宫产史、合并前置胎盘;胎盘植入患者发生产后出血、失血性休克、子宫切除及早产儿发生率均明显高于非植入组。结论高龄、经产妇、多次人流史及有剖宫产史或合并前置胎盘是发生胎盘植入的高危因素,对这些因素应充分重视;而且胎盘植入患者易出现严重的产后出血,导致母儿生命危险,应做好预防措施和抢救措施。

Objectives： To explore the related factors for placenta accreta and the effects on mother and child.Methods： The clinical data of 28 patients with placenta accreta admitted in this hospital during January 2002 to June 2012 were retrospectively compared to 200 patients without placenta accreta for maternal age,number of pregnancy and abortion,placental location,postpartum hemorrhage and premature delivery.Results： The occurrence of placenta accreta was related to high maternal age,more than two times of gravid and delivery,previous cesarean delivery and abnormal location of placenta.The incidence rates of postpartum hemorrhage,hemorrhagic shock,cesarean hysterectomy and preterm birth were significantly higher in group of placenta accreta,and their difference was significant（P0.05）.Conclusions： Placenta accrete is correlated with high maternal age,more than two times of gravid and delivery,previous cesarean delivery and placenta previa.Severe postpartum hemorrhage may lead to death of mother and fetus,so the prevention of above mentioned risk factors is very important in improving maternal and infantile life quality.