瘢痕子宫合并前置胎盘实施剖宫产术的临床效果

Clinical effect of cesarean section in cesarean uterus combined with placenta previa

目的分析瘢痕子宫合并前置胎盘实施剖宫产术的临床结局。方法回顾性分析在我院因前置胎盘而选择剖宫产的74例产妇的临床资料,其中37例产妇既往有剖宫产史,为瘢痕子宫合并前置胎盘,纳入试验组;另外37例产妇既往无剖宫产史,为单纯性前置胎盘,纳入对照组。两组产妇均实施剖宫产术,比较两组产妇的妊娠结局。结果试验组产妇的产后出血发生率和产后24 h平均出血量均明显高于对照组(P<0.05)。试验组的胎盘粘连、胎盘植入、产褥感染及子宫切除发生率均明显高于对照组(P<0.05)。试验组胎儿窘迫、新生儿窒息的发生率均高于对照组(P<0.05)。结论瘢痕子宫合并前置胎盘产妇实施剖宫产术的临床结局并不乐观,威胁母婴生命安全。首胎不存在剖宫产指征的产妇应尽量选择顺产,降低初产妇剖宫产率。

Objective To analyze the clinical outcomes of cesarean section in cesarean uterus combined with placenta previa.Methods The clinical data of 74 cases of maternals who were treated with cesarean section in our hospital due to placenta previa were retrospectively analyzed.Thirty-seven cases of maternals who had cesarean section history were cesarean uterus combined with placenta previa,and were enrolled into the experimental group.Another 37 maternals had no history of cesarean section were enrolled into the control group.All the maternals were treated with cesarean section.The pregnancy outcomes of the two groups were compared.Results The incidence of postpartum hemorrhage and average bleeding amount within postpartum 24 h in the experimental group were significantly higher than those in the control group(P<0.05).The incidences of placental adhesions,placenta accreta,puerperal infection and hysterectomy in the experimental group were significantly higher than those in the control group(P<0.05).The incidences of fetal distress and neonatal asphyxia in the experimental group were higher than those in the control group(P<0.05).Conclusion The cesarean section in cesarean uterus combined with placenta previa does not have positive clinical outcome,it will threaten the safety of mother and child life.The maternals with no cesarean section indications of the first pregnancy should try to choose natural delivery,so as to reduce the rate of maternal cesarean section.