前置胎盘发病因素及其妊娠结局的临床分析

Clinical analysis on pathogenic factors and pregnancy outcome of placenta previa

目的：探讨前置胎盘的发病因素及其妊娠结局。方法：选择2009年8月-2013年8月在医院分娩的118例前置胎盘产妇作为研究对象,回顾性分析前置胎盘的类型、发病的相关因素及治疗情况,并随机抽期同期在医院分娩无胎盘异常的产妇118例作为对照组。结果：高龄、经产、≥2次人工流产、引产、剖宫产手术与前置胎盘的发生有直接影响;不同类型前置胎盘其产前出血、产后出血发生率亦不同,中央性前置胎盘发生产前出血概率大（P〈0.01）、产后出血量最多（P〈0.01）、子宫切除率最高（P〈0.01）、临床结局最严重。结论：高龄、经产、≥2次人工流产、引产、剖宫产手术与前置胎盘密切相关;前置胎盘的妊娠结局与其类型及产前出血情况相关,中央性前置胎盘产前出血概率大、出血量多、严重威胁母儿生命。积极防治和及早诊断前置胎盘、加强产前保健和监护、延长孕龄、适时终止妊娠、关键控制出血可以改善围生期母婴结局。

Objective： To explore the pathogenic factors and pregnancy outcome of placenta previa. Methods： A total of 118 patients with placenta previa giving birth to their babies in the hospital from August 2009 to August 2013 were selected as study objects; the types, related pathogenic factors and treatment were analyzed retrospectively; 118 women without placenta previa giving birth to their babies during the same period were randomly selected as control group. Results： Advanced age, muhiparity, artificial abortion for two times or more than two times, induced labor and cesarean section had direct impacts on the occurrence of placenta previa; the incidence rates of antenatal hemorrhage and postpartum hemorrhage in placenta previa of different types were different, the incidence rate of antenatal hemorrhage, the amount of postpartum hemorrhage and the rate of uterectomy in central placenta previa were the highest （ P 〈 0. 01 ）, the clinical outcome was the severest. Conclusion： Advanced age, multiparity, artificial abortion for two times or more than two times, induced labor and cesarean section are closely correlated with placenta previa ; the pregnancy outcome of placenta previa is related to the types of placenta previa and an- tenatal hemorrhage; the incidence rate of antenatal hemorrhage and the amount of postpartum hemorrhage in central placenta previa are high, which has serious threat to mothers and their infants ; active prevention and treatment, timely diagnosis of placenta previa, strengthening antenatal health care and monitoring, prolonging gestational age, terminating pregnancy timely and controlling bleeding can improve perinatal outcome.