不同类型凶险性前置胎盘的母婴结局分析

Analysis of maternal and infant outcomes of different types of dangerous placenta previa

目的探讨凶险性前置胎盘合并胎盘植入与不合并胎盘植入对母婴结局的影响。方法回顾性分析2015年2月一2019年2月在内蒙古医科大学附属医院住院剖宫产分娩的凶险性前置胎盘患者83例,根据术前超声检查及术中情况分为单纯凶险性前置胎盘组(A组,n=33)和凶险性前置胎盘合并胎盘植入组(B组,”=50),比较两组患者的一般情况、产时及产后并发症和新生儿临床结局。结果两组在此次剖宫产与上次剖宫产间隔时间、既往试产率、既往流产次数的分布上差异有统计学意义(P均V0.05)。两组在产后出血、子宫切除、产褥期感染、失血性休克以及弥散性血管内凝血(DIC)等并发症的发生率差异有统计学意义(P均V0.05)。两组患者在早产、新生儿呼吸窘迫、新生儿贫血及其他并发症上的发生率差异无统计学意义(P均〉0.05)。结论择期剖宫产再次妊娠更容易发生凶险性前置胎盘合并胎盘植入;当患者发生凶险性前置胎盘合并胎盘植入时,产后出血、子宫切除及失血性休克等风险明显高于单纯凶险性前置胎盘;凶险性前置胎盘类型不影响新生儿结局。

Objective To investigate the effect of placenta previa with or without placenta implantation on maternal and infant outcomes.Methods A retrospective analysis of 83 cases of dangerous placenta previa delivered by cesarean section in our hospital from February 2015 to February 2019 was conducted.According to the preoperative ultrasound examination and intraoperative conditions,they were divided into simple dangerous placenta previa group(A group»n=33)and the group of dangerous placenta previa combined with placenta implantation(B group,n=50)・The basic data,intrapartum and postpartum complications and neonatal outcomes of the two groups were compared.Results There were statistically significant differences between the two groups in the interval time between this cesarean section and the last cesarean section,the previous trial birth rate,and the distribution of the previous abortion frequency(all P < 0.05). The incidence of complications such as postpartum hemorrhage, hysterectomy, puerperal infection,hemorrhagic shock and disseminated intravascular coagulation (DIC) between the two groups was statisticallysignificant (P<O.05). There was no significant difference in the incidence of premature birth, neonatalrespiratory distress, neonatal anemia and other complications between the two groups (all P >0.05)・Conclusion The cases with the history ofelective cesarean section was more likely to occur dangerous placentaprevia combined with placental implantation. The risk of postpartum hemorrhage, hysterectomy andhemorrhagic shock was significantly higher in patients with dangerous placenta previa combined with placentalimplantation. The dangerous placenta previa type did not affect neonatal outcome.