超声检测在评估前置胎盘孕妇分娩出血中的作用

目的 探讨产前超声检查结果与前置胎盘产妇分娩时发生大出血的关系.方法 选取2012年1月至2016年4月在海南省人民医院进行分娩的69例持续性前置胎盘孕妇进行研究,所有产妇产前均接受超声检查,明确胎盘附着位置、前置胎盘的类型等指标,按照是否并发分娩大出血分为两组进行比较,探讨产前超声检查相关结果与并发分娩时大出血的关系.结果 大出血组的前置胎盘类型、胎盘主要附着部位、距宫颈内口距离、有无胎盘缺损、胎盘植入率、既往子宫手术史与非大出血组比较差异具有统计学意义(x2值分别为10.498、7.767、5.219、7.371、32.116、7.136,均P＜0.05);大出血组的年龄、分娩史与非大出血组比较差异无统计学意义(t=0.600,x2=2.755,均P＞0.05);中央前置胎盘、胎盘主要附着于前壁、存在胎盘缺损、胎盘植入、既往子宫手术史是分娩大出血的危险因素(OR值分别为1.558、1.392、1.428、1.908,1.302,均P＜0.05);距宫颈内口距离≥2cm是莆置胎盘产妇并发分娩大出血的保护性因素(OR=0.763,P＜0.05).结论 根据产前超声检查结果可以对前置胎盘产妇并发分娩大出血的危险性进行预测和评估.

Role of ultrasonography in evaluating intrapartum hemorrhage in placenta previa

Objective To investigate the relationship between the results of prenatal ultrasonography and the occurrence of hemorrhage in delivery of women with placenta previa.Methods From January 2012 to April 2016 in Hainan General Hospital 69 pregnant women with persistent placenta previa were studied,and they underwent prenatal ultrasound examination to make sure placental location and the type of placenta previa as well as other indicators.The cases were divided into two groups according to whether complicating delivery bleeding to discuss the relationship between results of prenatal ultrasound and concurrent childbirth bleeding.Results The type of placenta previa,placental location,distance to mouth of cervix,placental defect,placenta implantation rate and previous history of uterine surgery in hemorrhage group were statistically different from those in non-hemorrhage group (x2 value was 10.498,7.767,5.219,7.371,32.116 and 7.136,respectively,all P ＜0.05).There were no statisical differnces in age and birth history between hemorrhage group and nonhemorrhage group (t =0.600,x2 =2.755,both P ＞0.05).Central placenta previa,mainly attached to the front wall,placental defect,placental implantation and previous uterine surgery were risk factors of childbirth bleeding (OR value was 1.558,1.392,1.428,1.908 and 1.302,respectively,all P ＜ 0.05).Distance to mouth of cervix larger than 2cm was the protective factor of placenta previa complicating hemorrhage (OR =0.763,P ＜ 0.05).Conclusion Results of prenatal ultrasound can be used to predict and evaluate the risk of placenta Drevia complicating hemorrhage in delivery.