剖宫产手术史对中央性前置胎盘患者妊娠结局的影响

目的 探讨剖宫产手术史对中央性前置胎盘(PP)患者妊娠情况和结局的影响.方法 选择安徽省妇幼保健院2012年1月至2015年12月收治的87例中央性PP患者,根据患者有无剖宫产史,将其分为剖宫产组(24例)与非剖宫产组(63例),剖宫产组患者再分为凶险性PP组和非凶险性PP组,分别比较剖宫产与非剖宫产组、凶险性和非凶险性PP组的妊娠情况及妊娠结局.结果 剖宫产组有人流史的患者比例为70.83%、产后出血量≥1000 mL 的发生率为25.00%、胎盘植入发生率为20.83%,均高于非剖宫产组,差异有统计学意义(P<0.05).凶险性PP组胎盘植入的发生率为38.46%,高于非凶险组,差异有统计学意义(P<0.05).结论 中央性PP可导致产后出血及胎盘植入的发生,特别是有剖宫产史的患者,产后出血量(≥1000 mL)及胎盘植入的发生率明显增加,应严格限制无指征的剖宫产.

Effects of history of cesarean section on pregnancy outcome of patients with central placenta previa

Objective To investigate the effects of the history of cesarean section onpregnancy and outcome of patients with central placenta previa.Methods Aretrospective analysis was performed on 87 cases of central placenta previa in Anhui Women and Child Health Care Hospital from January 2012 to December 2015.All cases were divided into cesarean section group(24 cases)and noncesarean section group(63 cases).In cesarean section group, the patients were divided into pernicious placenta previa and non pernicious placenta previa, which respectively were compared in terms of the pregnancy condition and pregnancy outcome.Results Theratioofpatients with a history of abortionin cesarean section group was 70.83%, the amount of postpartum hemorrhage was greater than 1000 mL, the incidence rate was 25%, placenta implantation rate was 20.83%,which were allhigher than those of non cesarean section group,and the difference was statisti-cally significant(P<0.05).The incidence of placental implantation in pernicious PP group was 38.46%,which was higher than that in non pernicious group,and the difference was statistically significant(P<0.05).Conclusion Central placenta previa can lead to postpartum hemorrhage and placenta implantation,especially the central placenta previa with a history of cesarean section,which significantly increases the incidence of postpartum hemorrhage(≥1 000 mL)and placenta implantation,thus the cesarean section with no indication should be strictly restricted.