凶险性前置胎盘不同胎盘附着部位对妊娠结局的影响

Effect of Different Placental Attachment Position on the Pregnancy Outcome of Pernicious Placenta Previa

目的:探讨不同胎盘主体附着部位对凶险性前置胎盘妊娠结局的影响。方法:回顾性分析2017年12月—2021年4月广西壮族自治区人民医院诊断为凶险性前置胎盘的患者234例。根据胎盘主体附着部分为3型:Ⅰ型为后侧壁向前包绕型(86例),Ⅱ型为前侧壁向下生长型(126例),Ⅲ型为胎盘宫颈外口浸润型(22例)。比较3组患者术中出血量、手术时间、术后住院时间、子宫切除率和胎盘植入率。结果:Ⅲ型为患者的术中出血量、手术时间、术后住院时间、子宫切除率和胎盘植入率大于Ⅰ、Ⅱ型患者,差异有统计学意义(均P<0.05),Ⅱ型患者子宫切除率大于Ⅰ型患者,差异有统计学意义(P<0.05)。结论:凶险性前置胎盘患者胎盘主体附着部位与妊娠结局存在相关性。在凶险性前置胎盘患者中,宫颈外口浸润型胎盘妊娠结局较差。

Objective:To investigate the effect of different placental attachment position of placenta on the pregnancy outcome of placenta previa.Methods:Retrospectively reviewed and analyzed the clinical records of 234 patients with pernicious placenta previa diagnosed in The People′s Hospital of Guangxi Zhuang Autonomous Region between December 2017 and April 2021.According to the different placental attachment positions,the patients with pernicious placenta previa were divided into three groups,groupⅠ(86 patients):placenta previa with posterior lateral wall anterior growth,groupⅡ(126 patients):placenta previa with anterior wall downward growth,groupⅢ(22 patients):placenta previa with cervical external orifice infiltration.The differences of intraoperative blood loss,hysterectomy rate,length of operation time,incidence of placenta accreta and postoperative hospital days were compared among groupⅠ,groupⅡand groupⅢ.Results:In terms of intraoperative blood loss,length of operation time,postoperative hospital days,incidence of placenta accreta and hysterectomy rate,groupⅢwas significantly higher than groupⅠand groupⅡ(P<0.05).In terms of hysterectomy rate,groupⅡwas significantly higher than groupⅠ(P<0.05).Conclusions:The placental attachment position with pernicious placenta previa is correlated with pregnancy outcome.In patients with dangerous placenta praevia,the pregnancy outcome of the invasive placenta extrauterine cervix was poor.