89例前置胎盘患者临床结局的回顾性分析

Retrospective analysis of clinical outcomes in 89 gravidas with placenta praevia

目的 探讨前置胎盘的类型、阴道出血状况与妊娠结局的关系。方法 将 89例前置胎盘分为轻度组 ( 4 3例 )及重度组 ( 4 6例 ) ,对其临床表现及妊娠结局做回顾性分析。结果 重度组初次出血及诊断时孕周均明显小于轻度组 (P <0 0 5) ;而产前出血发生率、出血次数及大出血例数无显著性差异 (P >0 0 5)。有产前出血者其诊断及分娩时的孕周、新生儿体重均显著低于无出血者 ( P <0 0 1 ) ;急诊剖宫产率显著高于无出血者(P <0 0 1 )。结论 前置胎盘患者妊娠结局有很大的差异 ,没有典型的临床特征可循。其类型及产前出血状况不能预测其结局 ,也不能据此提前做出处理方案。

Objective To investigate relationship between the degree of placenta praevia, vaginal bleeding and clinical outcomes.Methods Records of 89 patients with placenta praevia(mild praevia group 43; severe praevia group 46) were reviewed retrospectively, and outcomes were compared.Results The gestational age at the first bleeding and diagnosis was significantly smaller in severe group than that in mild one (P<0 05).The incidence of antepartum haemorrhage, the times of bleeding and the episodes of heavy bleeding in two groups showed no significant differences(P>0 05). The gestational age at diagnosis and delivery and birthweight were significantly smaller in women with antepartum bleeding than in those without(P<0 01). The number of deliveries by emergency caesarean section in women with antepartum bleeding was significantly higher than that in those without(P<0 01).Conclusion The clinical outcomes of placenta praevia are highly variable. There are no obvious clinical features that are typical in predicting the clinical outcomes. The number of bleeding episodes and the degree of praevia are not associated with outcomes, so they can’t be the proof to determine the treatment plan ahead of time.