159例前置胎盘妊娠结局的临床分析

目的探讨三种前置胎盘类型的病因、临床表现及妊娠结局。方法将10年间的159例前置胎盘按类型分为边缘性（80例）、部分性（32例）、完全性（47例）三组，并将临床资料进行回顾性比较分析。结果前置胎盘的发生率为1．98％，其中边缘性0．99％，部分性0．4％，完全性0．58％。高龄、多产、流产、剖宫产均为发生前置胎盘的高危因素，三组前置胎盘患者产前出血、输血、诊断孕周、分娩孕周、阴道分娩、早产、剖宫产率比较差异均有统计学显著意义（P〈0．05）；三组产后出血、失血性休克、切除子宫、急诊剖宫产、择期剖宫产、新生儿体重、窒息及围产儿死亡比较，差异均元统计学意义（P〉0．05）。完全性新生儿体重平均只有2470．2g。结论前置胎盘的临床表现、妊娠结局与其类型有关，完全性及部分性前置胎盘临床症状较重，母儿预后较差，早诊断、早治疗可降低并发症发生率。

Pregnancy outcome in 159 cases of placenta previa

Objective To explore the causes, clinical manifestations and outcome of pregnancy three types of placenta previa. Methods One hundred and fifty-nine cases of placenta previa during ten years were separated into three groups according to type： Marginal type （80 cases）, partial type （32 cases） and complete type （47 cases）. Meanwhile, the clinical data were retrospectively analyzed. Results The incidence of placenta previa was 1.98%. 0. 99% of them were marginal type;0. 4% of them were partial type;0.58% of them were complete type. Advanced reproductive age, prolificacy, abortion and the occurrence of cesarean section were the high risk factors causing the placenta previa. Compared between the three groups of patients who had placenta previa in terms of antepartum haemorrhage, blood transfusion, diagnosis gestational age, birth gestational age, vaginal delivery, prematurity and cesarean section rates, it showed the differences were significant （ P 〈 0. 05 ） ; But compared between three groups in trems of postpartum hemorrhage, hemorrhagic shock, removal of the uterus, emergency cesarean section, cesarean section optional, birth weight, asphyxia and perinatal death, it showed no significant difference （P 〉 0.05）. And the average birth weight of a complete type＇ s newborn baby was only 2 470. 2 grams. Conclusion The clinical manifestations of placenta previa and its pregnancy outcome is related to its type. The complete and partial types of placenta previa show more serious clinical symptoms and poor maternal and fetal prognosis. Early diagnosis and early treatment can reduce the incidence of complications.