60例前置胎盘临床分析及预测其产后出血的相关因素研究

Clinical analysis in 60 cases of placenta previa and study on related factors for predicting postpartum hemorrhage

目的研究前置胎盘临床及影像学特点,预测围生期出血量。方法纳入该院2018年1月至2019年1月前置胎盘住院手术患者60例。回顾性分析临床基本信息、超声影像学特点、临床处理及临床结局。结果60例病例分为出血量<1500 mL与≥1500 mL两组;其中术前超声评分、手术时间、术中输血、术中是否行子宫切除、是否行盆腔血管结扎术、术后24 h出血量>500 mL,在两组中差异有统计学意义(P<0.05);而术前是否贫血、术中子宫双切口等,在两组中差异无统计学意义。通过ROC曲线制定可对胎盘植入类型进行预测,当评分<8分时,考虑为粘连型胎盘,评分≥8分时,考虑为植入型胎盘;当评分<14分时,考虑为植入型胎盘,评分≥14分时,考虑为穿透型胎盘。结论通过术前超声评分界值可准确预测前置胎盘术中出血情况及类型。

Objective To study the clinical and imaging features of placenta previa,and to predict the amount of perinatal bleeding.Methods A total of 60 inpatients with placenta previa operation in this hospital from January 2018 to January 2019 were included.The clinical basic information,ultrasound imaging characteristics,clinical treatment and clinical outcomes were retrospectively analyzed.Results Sixty cases were divided into the two groups with blood loss<1500 mL and 1500 mL;among them,the preoperative ultrasound score,operation time,intraoperative blood transfusion,whether conducting intraoperative hysterectomy,and postoperative 24 h blood loss volume>500 mL had statistical differences between the two groups(P<0.05);while whether existing anemia before operation and double uterine incisions during operation had no statistically significant difference between the two groups.Formulating the ROC curve could predict the type of placenta implantation.When the score was less than 8 points,it was considered to be an adhesive placenta;when the score was≥8 points,it was considered to be an implanted placenta;when the score was<14 points,it was considered to be an implanted placenta;when the score was≥14 points,it was considered to be a penetrating placenta.Conclusion The preoperative ultrasound score cut-off can accurately predict the intra-operative bleeding and type of placenta previa.