子宫动脉栓塞术对孕妇前置胎盘中晚孕引产时出血的影响

目的探讨子宫动脉栓塞术（UAE）对中晚期妊娠伴前置胎盘引产术中出血的影响。方法2014年1月至2015年10月自愿要求提前终止妊娠的中晚期妊娠伴前置胎盘孕妇68例，根据是否行UAE分为2组：36例行UAE联合利凡诺羊膜腔注射引产孕妇为观察组，另32例单纯行利凡诺羊膜腔注射引产孕妇为对照组，对比两组的产后出血情况及引产结局。结果观察组产时出血量、产后2h出血量及产后住院时间比对照组显著减少（P〈0．05）；两组产后腰骶部疼痛发生率差异无统计学意义（P〉0．05），观察组产后发热、阴道渗血、失血性休克率显著低于对照组（P〈0．05）。结论UAE应用于中晚期妊娠伴前置胎盘孕妇的引产手术中有利于减少产时及产后出血，降低产后并发症发生率，改善临床预后。

Objective To observe uterine artery embolization （ UAE ） on effect of bleeding during middle-late pregnancy induced labor of pregnant women with placenta previa. Methods 68 cases of pregnant women with middle-late pregnancy with placenta previa from January 2014 to October 2015 in our hospital who were willing to terminate the middle and late pregnancy with placenta previa, and they were divided into groups according to whether they were given UAE： 36 cases of pregnant women were treated with UAE combined with rivanol injection induced abortion who were selected as the observation group, and another 32 cases of pregnant women were treated with rivanol injection induced abortion who were selected as the control group, postpartum hemorrhage and outcome of induced abortion of two groups were compared. Results The amount of bleeding of delivery, the amount of postpartum 2H bleeding and postpartum hospitalization were significantly reduced than those of the control group （ P〈0.05 ） ; There was no significant difference in the incidence of pain in the lumbar and sacral region of the postpartum between two groups （ P〉0.05 ） , postpartum fever, vaginal bleeding, the rate of uncontrolled hemorrhagic shock of the observation group were significantly lower than those of the control group （ P〈0.05 ） . Conclusion Application of UAE in the induction of labor in middle and late pregnancy with placenta and placenta of pregnant women is beneficial to reduce the production and postpartum hemorrhage, reduce the incidence of postpartum complications, and improve the clinical prognosis.