凶险型前置胎盘29例临床分析

Clinical analysis of 29 cases of pernicious placenta praevia

目的探讨凶险型前置胎盘对孕产妇的危害，提高对凶险型前置胎盘的认识。方法回顾性分析本院2008年1月～2012年12月收治凶险型前置胎盘患者29例，严格观察和计算患者术中出血量，剖宫产术中大出血率，胎盘植入率及胎盘位置进行分析，归纳总结术中出血的原因。结果所有患者均为中央型前置胎盘，其中胎盘附着于后壁向前绕过宫颈内口至前壁下段者14例，平均术中出血约300ml；胎盘附着于前壁向前绕过宫颈内口至后壁下段者15例，其中无胎盘植入者7例，平均术中出血约400ml，有胎盘植入者7例，平均术中出血约3500ml，其中6例行子宫切除术。结论凶险型前置胎盘极易导致严重的产后大出血，严重的威胁孕产妇及围生儿生命，需充分做好母婴保健工作，严格控制剖宫产率。

To explore the harm of pernicious placenta previa on maternal to improve the understanding of the pernicious placenta previa. Methods Retrospective analysis of 29 patients in our hospital from 2008 January to 2012 December were pernicious placenta praevla, strict observation and calculation of intraopemtive bleeding volume, hemorrhage in cesarean section rate, placenta implantation rate and placental location for analysis, summarized the intraoperative bleeding. Results All patients were central type of placenta previa, in which there were 14 eases with placenta attached to the wall after bypass intracervical mouth forward to front wall under section, the average intraoperafive bleeding was about 300 ml; 15 cases with placenta attached to the front wall wall after bypass intracervical mouth to paragraph, in which 7 cases with no placenta accreta, the average intraoperative bleeding was about 400 ml, 7 eases with placenta accreta, the average intracperative bleeding was about 3500 ml, 6 eases were underwent hysterectomy. Conclusion The pernicious placenta previa is extremely easy to cause severe postpartum hemorrhage, which is aserious threat to maternal and perinatsl life, so need to fully complete the work of maternal and infant health care, strictly control the cesarean rate.