凶险性前置胎盘32例临床分析

目的探讨凶险性前置胎盘的孕期、围手术期临床特点。方法53例前置胎盘患者，其中凶险性前置胎盘32例（凶险前置胎盘组），初次剖宫产前置胎盘21例（初次前置胎盘组）；比较2组一般资料、围手术期资料、围产儿资料等。结果2组年龄、确诊时孕周、分娩时孕周、文化程度、职业、Apgar评分〈7比例、出生体质量、是否转NICU比较差异无统计学意义（P〉0．05）；2组孕次、产次、产后出血量、产后出血率、手术时间、子宫切除率、肠粘连松解率、输血率、胎盘植入率、早产发生率比较差异有统计学意义（P〈0．05）。结论凶险性前置胎盘的产后出血率、胎盘植入率、子宫切除率、输血率及早产率较高，早期干预可降低母婴致病率及病死率。

Clinical analysis of placenta previa with previous caesarean section in 32 patients

Objective To investigate the clinical features of placenta previa with previous caesarean section during pregnancy and peroperative period. Methods Fifty-three patients with placenta previa included 32 patients with placenta previa with previous caesarean section （group A） and 21 patients with initial placenta previa （group 13）. The general data, peroperative data and neonatal data were analyzed and compared between two groups. Results There were no significant differences in the mean age, gestational week at diagnosis, gestational week at delivery, education level, occupation, Apgar score, mean neonatal weight, and transferring to NICU between two groups （P 〉 0.05）. And there were significant differences in gravidity, parity, postpartum hemorrhage, operation duration, hysterectomy rate, enterolysis rate, blood transfusion rate, placenta aecreta and preterm birth rate between two groups （P〈0.05）. Conclusions The patients with placenta previa with previous caesarean section have higher rates of postpartum hemorrhage, placenta accreta, hysterectomy, blood transfusion and preterm birth. Early intervention can reduce the maternal and fetal pathogenic rate and fatality.