前置胎盘126例并胎盘植入者3例临床分析

目的探讨前置胎盘及胎盘植入的临床特征及合适处理。方法对我院1996年1月至2004年1月收治的126例前置胎盘患者的临床资料进行回顾性分析。结果住院分娩产妇16320例中,前置胎盘126例,发生率为0.8%,其中合并胎盘植入的3例均属中央型,占前置胎盘总数的2.4%。有宫腔操作史者96例,占76.2%。中央性前置胎盘26例,部分性34例,边缘性66例,分别占20.6%,26.9%,52.4%。行剖宫产术98例(77.8%),阴道分娩28例(22.2%)。3例胎盘植入的有2例行子宫次全切除,1例经MTX化疗保守治疗。孕产妇死亡率为0,新生儿窒息22例(17.5%),新生儿存活率100%。结论随着前置胎盘及胎盘植入发病率的增加,选择合适的处理方法显得尤为重要。积极期待疗法加适时的手术处理,将有助于降低母婴死亡率和发病率。

Clincal Analysis of 126 Cases of Placenta Previa and 3 Cases of Placenta Accrete

Objective To analyze the risk factors of placenta previa and placenta accrete, and the matemal newbom outcome. Method Retrospective study of placenta previa (126 cases) and placenta accrete (3 cases) was performed. Hospital records between January 1996 and January 2004 were analyzed. Result Among 163,200 partuients, one hundred and twenty six cases (0.8%) had placenta previa, and three (2.4%) of them had placenta accreta. 96 cases (76.2%) had a history of previous uterine surgical manipulation. Out of the 126 cases of placenta previa, 26 cases (20.6%) were complete placenta previa, 34 cases (26.9%) were partial and 66 cases were (52.4%) marginal. Ninetyeight women(77.8%) underwent cesarean section. All three cases of placenta accreta came from complete placenta previa, two of them underwent subtotal hysterectomy, one of them succeeded after conservative management and methotrexate treatment. There was no matemalnewbom matality. Newborn asphyxia rate was 17.5%. Survival rate for the newborn was 100%. Conclusion With the increasing incidence of placenta previa and placenta accreta, selection of an appropriate method is important. Appropriate patient management and surgical technique may reduce mortality and morbidity related to this condition.