黄河三角洲地区剖宫产术与前置胎盘关系探讨

目的 探讨黄河三角洲地区育龄女性剖宫产术与再次妊娠时前置胎盘及其相关疾病发生的关系。方法 调查统计黄河三角洲地区2013年1月至2017年10月各级医疗中心的相关数据进行回顾性分析研究。本次研究收集符合条件的前置胎盘患者为实验组,另外在符合条件的非患者中随机抽选出3倍于实验组的人数作为对照组进行匹配,控制其他独立风险因素的干扰。结果 本研究实验组与对照组筛选出符合条件的患者分别为24 515例、73 545例,其中前置胎盘患者分别为482例、407例,胎盘植入患者分别为83例、14例,两组前置胎盘并发胎盘植入患者为52例、7例,大部分胎盘位于子宫前壁患者分别为10 323例、35 653例,大部分位于子宫后壁者分别为14 192例、37 892例。实验组与对照组比较其前置胎盘与胎盘植入分析结果分别为OR=3.55,CI3.17-4.05],OR=17.79,CI10.10-31.33],P均＜0.001;实验组大部分胎盘位于子宫前壁与后壁的前置胎盘分析结果为OR=1.49,CI1.25-1.79],胎盘植入数据为OR=5.79,CI3.35－9.99],P均＜0.005;对照组患者中大部分胎盘位于子宫前壁与后壁的前置胎盘分析结果为OR=0.99,CI0.81-1.20],胎盘植入数据为OR=1.42,CI0.49-4.09],P均＞0.05。结论 黄河三角洲地区育龄期女性先前剖宫产史是其再次妊娠时前置胎盘和胎盘植入的风险因素,且胎盘位置与两者也有一定联系,提示妇产医务人员需尽早采取筛查预防及治疗措施并给予正确的妊娠指导。

Relationship between cesarean section and placenta previa in the Yellow River Delta

Objective To explore the relationship between cesarean section and placenta previa and related diseases during second pregnancy of women at childbearing age in the Yellow River Delta region.Methods Related data were retrospectively analyzed from medical centers at all levels in the Yellow River Delta region from January 2013 to October 2017. In this study, the eligible placenta previa patients were selected as the experimental group. In addition, among eligible non-patients, 3 times the number of the experimental group was randomly selected as the control group for matching, and other independent risk factors were controlled.Results In the study group and the control group,24 515 cases and 73 545 cases were found to be eligible, including 482 cases and 407 cases of placenta previa, 83 cases and 14 cases of placenta accreta,and placenta previa in both groups.There were 52 cases and 7 cases of concurrent placenta accretion.The majority of placentas located in the anterior wall of the uterus were 10 323 cases and 35 653 cases respectively, and most of them located in the posterior wall of the uterus were 14 192 cases and 37 892 cases respectively.The results of placenta previa and placenta accreta analysis in the experimental group compared with those in the control group were OR=3.55,CI3.17－4.05],OR=17.79,CI10.10－31.33],both with P＜0.001.The placenta previa analysis of the placenta located in the anterior and posterior walls of the uterus was OR=1.49,CI1.25－1.79] in the experimental group,and the placental implantation data was OR=5.79,CI3.35－9.99],both with P＜0.005.The placenta previa analysis of most placentas in the anterior and posterior walls of the uterus was OR=0.99,CI0.81-1.20] in the control group,and placental implantation data was OR=1.42,CI0.49-4.09],both with P＞0.05.Conclusion The history of previous cesarean section in women of childbearing age in the Yellow River Delta region is a risk factor for placenta previa and placenta accreta during second trimester pregnancy,and the location of the placenta is also related to both above, suggesting that maternity medical staff need take measures for screen, prevention and treatment as soon as possible and need to give correct pregnancy instructions.