前置胎盘合并胎盘植入17例临床分析

目的 探讨前置胎盘合并胎盘植入的高危因素及处理方法。方法 回顾性分析我院2000年1月～2004年11月住院治疗的139例前置胎盘，其中合并胎盘植入17例。结果 前置胎盘合并胎盘植入发生率12．23％；很少发生产前出血的中央型前置胎盘多有胎盘植入；胎盘植入组即使产前出血，其次数及出血量较无胎盘植入者低。结论 对不发生或极少发生产前出血，有多次孕产史的中央型前置胎盘，要考虑胎盘植入。浆膜面全肌层缝扎止血法可成功保留子宫，值得推广应用。

Clinical analysis of 17 cases of placenta previa with placenta accreta

[Objective] To explore the high risk factors and management of placenta previa complicated with placenta accreta. [Method] Retrospectively analyzed all the 139 cases of placenta previa hospitalized in the hospital from 2000 January to 2004 November, of which 17 cases complicated with placenta accreta. [Result] The incidence rate of placenta previa with placenta aacreta was 12.23%; the patient with central placenta previa who seldom occurred antepartum hemorrhage was complicated with placenta accreta; and even if antepartum hemorrhage happened in the group of placenta accreta, the times and quantity of hemorrhage were lower than non-placenta accreta group. [Conclusion] When there is no or little hemorrhage during third trimester in patients with central placenta previa and many parities, placenta accreta must be considered. Transfixion hemostasis of all muscular layer through serous membrane can reserve uterus successfully and it is worth generalizing.