凶险型前置胎盘的相关因素及围生期结局分析

Analysis of the related factors and perinatal outcomes of the dangerous placenta previa

目的:分析凶险型前置胎盘的相关因素及围生期结局。方法:回顾性分析本院2015年1月—2017年12月收治的60例凶险性前置胎盘(观察组)及100例非凶险型前置胎盘(对照组)孕妇临床资料。对两组资料进行因素分析并比较围生期结局。结果:两组妊娠期糖尿病、妊娠期高血压发生情况比较无差异(P>0.05);观察组年龄、文化程度、居住地、产次、人工流产次数及剖宫产次均高于对照组(P<0.05)。logistic回归分析显示,年龄、文化程度、居住地、产次、人工流产次数及剖宫产次均为凶险型前置胎盘的独立危险因素。观察组产前出血、产后出血、早产儿、新生儿窒息及1min Apgar评分<7分发生率均高于对照组(P<0.05)。结论:高龄、低文化程度、居住地、多产次、多人工流产次数及多剖宫产次为凶险型前置胎盘发生的独立危险因素,临床应加强对高危孕妇的管理工作,以降低产后出血、早产等围生期结局的危险性。

Objective：To analyze the related factors and perinatal outcomes of the dangerous placenta previa.Methods：A retrospective analysis included the clinical data of 60 patients with dangerous placenta preplacenta（in observation group）and 100 patients with non-lethal placenta previa（in control group）who received therapy in maternal and child health care hospital of Gansu province from January 2015 to December 2017.The univariate analysis and multifactor analysis were used for analyzing the clinical data of women in both groups,and the perinatal outcomes were compared between the two groups.Results：The incident of gestational diabetes and gestational hypertension had no significant difference between the two groups（P〉0.05）.The age,education level,gravidity times,and number of abortion and cesarean section of women in observation group were all significantly higher than those of women in control group（P〈0.05）.There was significant difference in residence of women between the two groups（P〈0.05）.Logistic regression model analysis showed that the age,education level,residence,gravidity times,and number of abortion and cesarean section were the independent risk factors for the dangerous placenta.The volume of prenatal bleeding and postpartum hemorrhage,the rate of premature infant,neonatal asphyxia,and 1-minute Apgar score〈7 in observation group were significantly higher than those in control group（P〈0.05）.Conclusion：The older age,education level,residence,b gravidity times,and number of abortion and cesarean section are the independent risk factors for the dangerous placenta,so the management of high-risk pregnant women should be strengthened for reducing postpartum hemorrhage,and premature birth,and for decreasing other adverse perinatal outcomes.