不同类型前置胎盘的妊娠结局比较

Pregnancy outcome in different types of placenta previa

目的：比较不同类型前置胎盘对妊娠结局的影响。方法：回顾性分析2010年至2014年在响水县人民医院分娩的72例前置胎盘患者的临床资料。入选病例分为3组：完全性前置胎盘组18例,部分性前置胎盘组22例,边缘性前置胎盘组32例。比较3组患者的一般临床特征、产妇妊娠结局及围生儿结局。结果：完全性前置胎盘组产后出血的发生率高于边缘性前置胎盘组,完全性前置胎盘组和部分性前置胎盘组胎盘粘连的发生率高于边缘性前置胎盘组,差异均有统计学意义（均P〈0.05）。Logistic回归分析显示,胎盘粘连是发生产后出血的独立影响因素,OR值为22.950（95%CI=4.297-122.577）。结论：完全性前置胎盘患者产后出血的发生率较高,主要是因为其并发胎盘粘连的比率较高。完全性和部分性前置胎盘对产妇健康的不良影响较边缘性前置胎盘明显。

Objective： To compare pregnancy outcomes associated with different types of placenta previa（ PP）.Methods： A restropective analysis of 72 pregnacies complicated by PP was conducted,from 2010 to 2014.Pregnancies were classified into three groups： 18 pregnancies were of complete PP,22 pregnancies were of partial PP,32 pregnancies were of marginal PP. The general characteristics of pregnant women,maternal and perinatal outcomes were compared among three groups. Results： Women with complete PP had significantly higher frequency of postpartum hemorrhage than that of women with marginal PP（ P〈0. 05）. Compared to women with marginal PP,placenta accreta were complicated at higher rate in women with complete or partial PP（ P〈0. 05）. Logistic regression analysis revealed that placenta accreta was an independent influence factor on postpartum hemorrage（ OR = 22. 950,95% CI = 4. 297 - 122. 577）. Conclusion： Complete PP is associated with higher incidence of postpartum hemorrhage,and this association is chiefly due to higher rate of placenta accreta in complete PP.Complete or partial PP is associated with higher morbidity in comparison to marginal PP.