足月阴道分娩后胎盘粗糙的处理

Treatment in Patients with Coarseness of Placenta Following Term Vaginal Delivery.

目的:探讨足月阴道分娩后胎盘粗糙的处理原则。方法:观察并随访同期168例阴道分娩后胎盘粗糙病例和40例胎盘完整病例的临床处理和预后。结果:132例(78.57%)药物治疗成功,免于清宫;12例(7.14%)产后立即行清官术;24例(14.29%)产后4～5天行清官术。随访半年,未发现这部分病例发生晚期产后大出血和产褥感染,其恶露量、恶露干净时间与胎盘完整者相比无显著性差异(P>0.05)。结论:对足月阴道分娩后胎盘粗糙的处理应个体化,分层次进行。

Objective:To evaluate strategy of treatment in patients with coarseness of placenta following term vaginal delivery. Methods:A total of 168 cases with coarseness of placenta following vaginal delivery and 40 cases with completeness of placen- ta,whose clinical treatment and prognoses were analyzed and followed up.Resuhs:132 cases(78.57%)were avoided routine curettage by treatment with drugs; 12 casis(7.14%)were operated postpartum curettage immediately;24 cases(14.29%) were operated postpartum curettage after 4～5 days.Followed up for six months,none of them illed with late postpartum hemor- rhage and puerperal infection,There were no significant difference in lochia volume and duration by compared with normal(P >0.05).Conclusion:The cases with coarseness of placenta following vaginal delivery should be treated individually and be dealt with stratification,