帆状胎盘的临床特点及其对围产儿预后的影响

Clinical Characteristics of Velum Placenta and Its Influence on Perinatal Prognosis

目的分析帆状胎盘的临床特点并探究其对围产儿预后所产生的影响。方法对2017年10月—2021年10月北京市朝阳区妇幼保健院50例帆状胎盘孕产妇临床资料展开回顾性分析,将其研究数据命名为研究组,同时选择该时间段内非帆状胎盘孕产妇120例为参考组。50例帆状胎盘患者中有40例产前即诊断为帆状胎盘(产前明确组),有10例产后诊断为帆状胎盘(产后明确组)。通过比较产前明确组与产后明确组、参考组与研究组的临床结果,探究帆状胎盘的特点和对围产儿预后的影响。结果产前明确组与产后明确组比较,前者剖宫产率为95.00%明显高于后者60.00%,差异有统计学意义(χ^(2)=6.262,P<0.05);比较胎儿窘迫率,前者为15.00%低于后者60.00%,差异有统计学意义(χ^(2)=6.586,P<0.05);比较新生儿窒息率,前者为0.00%明显低于后者20.00%,差异有统计学意义(P<0.05)。参考组与研究组间比较,研究组剖宫产率、胎儿窘迫率和新生儿窒息率分别为90.00%、22.00%和6.00%,均显著高于参考组,差异有统计学意义(P<0.05)。比较围产儿预后指标,研究组平均孕周、出生体质量、脐动脉血pH分别为(35.17±4.64)周、(2005.29±945.87)g和(7.24±0.17),较参考组显著更低,差异有统计学意义(t=5.794、9.394、3.652,P<0.05)。结论帆状胎盘将对围产儿的生命安全带来极大威胁,当出现多个高发因素时,应结合其临床特点,产前尽早通过超声检查诊断,选择剖宫产适时终止妊娠,改善围产儿预后。

Objective To analyze the clinical characteristics of veliform placenta and to explore its influence on the prognosis of perinatal infants.Methods A retrospective analysis was carried out on the clinical data of 50 pregnant women with veliform placenta in Beijing Chaoyang District Maternal and Child Health Hospital from October 2017 to October 2021.The research data were named as the study group,and 120 pregnant women with non-sail placenta within this time period were selected as the reference group.Among the 50 patients with veliform placenta,40 cases were diagnosed as veliform placenta prenatally(prenatal definite group),and 10 cases were diagnosed as veliform placenta postpartum(postnatal definite group).By comparing the clinical results of the prenatal clear group and the postnatal clear group,the reference group and the study group,the characteristics of the veliform placenta and their influence on the prognosis of perinatal infants were explored.Results Compared with the prenatal clear group and the postpartum clear group,the cesarean section rate of the former was 95.00%,which was significantly higher than that of the latter 60.00%,the difference was statistically significant(χ^(2)=6.262,P<0.05);compared the fetal distress rate,the former was 15.00%lower than the latter 60.00%,the difference was statistically significant(χ^(2)=6.586,P<0.05);compared the neonatal asphyxia rate,the former was 0.00%significantly lower than the latter 20.00%,the difference was statistically significant(P<0.05).Comparison between the reference group and the study group,the cesarean section rate,fetal distress rate and neonatal asphyxia rate in the study group were 90.00%,22.00%and 6.00%,respectively,which were significantly higher than those in the reference group,the difference was statistically significant(P<0.05).Compared perinatal prognostic indicators,the mean gestational age,birth weight,and pH of umbilical artery blood in the study group were(35.17±4.64)weeks,(2005.29±945.87)g and(7.24±0.17),respectively,significantly lower than the reference group,the difference was statistically significant(t=5.794,9.394,3.652,P<0.05).Conclusion Veniform placenta will pose a great threat to the safety of perinatal infants.When there are multiple high-incidence factors,it should be diagnosed by ultrasonography as early as possible before birth,and cesarean section should be selected to terminate pregnancy in accordance with its clinical characteristics,so as to improve the prognosis of perinatal infants.