前置胎盘临床高危因素分析及其与妊娠结局的相关性研究

Clinical high risk factors for placenta previa and their correlation with pregnancy outcomes

目的探讨前置胎盘的临床高危因素及其对母婴的影响,为其预防提供理论依据。方法选取2010年9月—2013年6月期间住院的单胎前置胎盘孕产妇(112例)为研究组,同期住院的健康、单胎、非前置胎盘孕产妇(177例)为对照组,回顾性分析前置胎盘临床常见病因及其对母婴的影响。结果研究组中年龄≥35岁者43例,占38.4%,无业30例,占26.8%,工人32例,占28.6%,分娩史≥3次者29例,占25.9%,人工流产史≥3次者48例,占42.9%,剖宫产史者22例,占19.6%,盆腔炎史者39例,占34.8%,均高于对照组;经统计学分析比较,两组患者年龄、人工流产史、剖宫产史、分娩史、盆腔炎史差异有统计学意义(均P<0.05),Logistic回归分析显示,高龄、多次人工流产史、剖宫产史及分娩史暴露率相对较高,是前置胎盘的常见病因;两组产妇妊娠结局比较,研究组剖宫产、胎盘粘连、胎盘植入、产后出血、产褥期感染、早产、低出生体重儿、新生儿窒息发生率明显高于对照组,差异均有统计学意义(均P<0.05)。结论年龄、人工流产史、剖宫产史、分娩史是前置胎盘的高危因素,严重威胁母婴生命,应做好生殖卫生、实行计划生育、减少人工流产次数、降低剖宫产率等防治措施。

Objective To study the clinical high risk factors of placenta previa and their effects on pregnancy outcomes, so as to provide a theoretical basis for the prevention of placenta previa. Methods 112 cases of singleton pregnancies with placenta previa treated in our hospital from Sep. 2010 to Jun. 2013 were selected as the study group; 177 cases of healthy singleton pregnancies without placenta previa treated at the same period were selected as control group. The common causes of placenta previa and their effects on maternal health were analyzed retrospectively. Results In study group, there were 43 cases aged 35 years and above（ 8.4% ）, 30 cases unemployed（ 26.8% ） , 32 workers, （ 28.6% ） , 29 cases with 3 or more childbirths （ 25.9% ） , 48 cases with 3 or more abortion （ 42.9% ） , 22 cases with history of cesarean section （ 19.6% ）, 39 cases with history of pelvic inflammatory disease（ 34.8% ）, which were higher than those in control group. After statistics analysis, there were significant differences in age, abortion,cesarean section, childbearing and pelvic inflam matory disease between the two groups （ P 〈 0.05 ）. Logistic regression analysis showed that age, repeated history of in duced abortion , the history of cesarean section and delivery had a relatively high exposure rate and are common causes of placenta previa. In terms of pregnancy outcomes, study group had a significantly higher incidence of cesarean section, pla centa aecreta, placenta inereta, postpartum hemorrhage, puerperal infection, premature birth, low birth weight children and neonatal asphyxia than the controls ; and the difference was statistically significant （ P 〈 0.05 ）. Coneluslons Age,in duced abortion, cesarean section, and childbearing are high risk factors for placenta previa. As it is severely llfe threaten ing to mother and children, preventive measures should be carried out, such as maintenance of good reproductive health, im plementation of family planning, reduction of induced abortion and cesarean section rate.