摘要
目的探讨前置胎盘的临床特点及危险因素。方法 153例前置胎盘患者,其中完全性前置胎盘52例,部分性前置胎盘13例,边缘性前置胎盘88例;19例为凶险性前置胎盘,其中合并胎盘植入11例;19例合并胎盘植入;分析前置胎盘的诊断、妊娠结局以及导致产后出血、胎盘植入的危险因素。结果术前超声确诊前置胎盘92例,诊断率为60.1%,胎盘植入诊断准确率为42.1%(8/19);6例患者经会阴侧切分娩,147例以剖宫产终止妊娠(其中51例为未足月分娩),发生产后出血55例,其中11例凶险性前置胎盘并胎盘植入者,10例发生产后出血,6例行子宫切除术;有胎盘植入者流产次数和剖宫产次数与无胎盘植入者比较差异有统计学意义(P<0.05);胎盘植入与流产史(r=0.261,P=0.004)、剖宫产史(r=0.468,P=0.000)呈正相关,完全性前置胎盘(r=0.485,P=0.000)、合并胎盘植入(r=0.354,P=0.000)、有剖宫产史(r=0.247,P=0.002)与前置胎盘患者产后出血呈正相关。结论产前超声检查有助于前置胎盘及胎盘植入的诊断,完全性前置胎盘、合并胎盘植入及有剖宫产史的前置胎盘患者产后出血发生率高。
Objective To explore the clinical characteristics and risk factors of placenta previa. Methods In 153 cases of placenta previa, there were 52 cases of complete placenta previa, 13 of partial placenta previa and 88 of marginal placenta previa. Dangerous placenta previa was found in 19 cases including 11 cases of combination of placenta increta. Placenta increta was complicated in 19 cases. The diagnosis of placenta previa, pregnancy outcome and the risk {actors of postpartum hemorrhage and placenta increta were analyzed. Results A total of 95 cases of placenta previa were preoperatively diagnosed by color Doppler ultrasound with the diagnostic rate of 60. 1%. The diagnostic accuracy of ultrasound for placenta increta was 42.1% (8/19). Six patients received spontaneous labor under lateral episiotomy, and 147 patients received caesarean section (51 cases of premature childbirth delivery), in which postpartum hemorrhage occurred in 55 cases including 11 cases of dangerous placenta previa complicated with placenta increta, 10 cases of postpartum hemorrhage and 6 cases of hysterectomy. The abortion times and cesarean section times showed significant differences between the patients with and with no placenta increta (P〈0.05). Placenta previa was positvely correlated with the history of abortion (r=0. 261, P=0.004) and the history of cesarean section (r=0.468, P=0. 000). And complete placenta previa (r=0.485, P=0.000), placenta increta (r=0. 354, P=0.002) and the history of caesarean section (r=0. 247, P= 0. 002) were positively correlated with postpartum hemorrhage. Conclusion Prenatal ultrasound contributes to the diagnosis of placenta previa and placenta increta. The incidence of postpartum hemorrhage is high in the patients with complete placenta previa, placenta increta and the history of cesarean section.
出处
《中华实用诊断与治疗杂志》
2016年第7期672-674,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
北京市科技计划课题(Z13110000681304)
关键词
前置胎盘
胎盘植入
产后出血
Placenta previa
placenta increta
postpartum hemorrhage