晚期妊娠凶险性前置胎盘并胎盘植入15例临床分析

PERNICIOUS PLACENTA PREVIA WITH PLACENTA ACCRETA IN LATE PREGNANCY:A CLINICAL ANALYSIS OF 15 CASES

目的探讨凶险性前置胎盘并胎盘植入的发生率、诊断和治疗方法。方法对我院2011年10月—2014年12月收治的15例凶险性前置胎盘(中央型)并胎盘植入病人进行回顾性分析。结果瘢痕子宫孕妇凶险性前置胎盘并胎盘植入的发生率为3.49%。13例病人在产前经B超诊断,超声诊断率为86.7%。9例病人行子宫切除术(病理检查均确诊胎盘植入),6例病人出血部位行"8"字缝合,15例病人均手术效果良好,术后安全出院。结论 B超对凶险性前置胎盘并胎盘植入诊断率高;该病治疗方法和结局与胎盘侵入范围密切相关。

Objective To investigate the incidence rate,diagnosis,and treatment of pernicious placenta previa with placenta accreta in late pregnancy. Methods A retrospective analysis was performed for the clinical data of 15 patients with pernicious placenta previa（central type）complicated by placenta accreta who were admitted to our hospital from October 2011 to December 2014. Results The incidence rate of pernicious placenta previa complicated by placenta accrete in pregnant women with a scarred uterus was 3.49%.Of all patients,13（86.7%）were diagnosed by ultrasound before parturition.Nine patients underwent hysterectomy and had a confirmed diagnosis of placenta accrete on pathological examination,and six patients were given 8-character-pattern suturing at the bleeding sites.All patients had a good surgical outcome and were discharged safely after surgery. Conclusion Ultrasound has a high diagnostic rate of pernicious placenta previa with placenta accreta,and the therapies and outcome of this disease are closely associated with the extent of placenta invasion.