瘢痕子宫再次妊娠距上次剖宫产间隔时间与凶险性前置胎盘的关系

目的:探讨瘢痕子宫再次妊娠距上次剖宫产间隔时间与凶险性前置胎盘发生的关系。方法:选择2013年4月1日至2018年3月31日在河北省人民医院分娩的548例瘢痕子宫孕妇进行回顾性队列研究,其中48例为凶险性前置胎盘。按剖宫产后再次妊娠间隔时间从0年至10年以上,每隔1年为1组进行分组,共11组。结果:瘢痕子宫再次妊娠距上次剖宫产间隔时间不同凶险性前置胎盘的发生率不同,差异有统计学意义(P=0.000);用曲线回归方程进行验证,四种曲线方程拟合模型差异均有统计学意义(P=0.000);散点图提示剖宫产与再次妊娠间隔时间<1年及≥5年凶险性前置胎盘发生率较高;再次妊娠间隔时间<1年及≥5年与1年≤间隔时间<5年比较,凶险性前置胎盘的发生率差异有统计学意义(P=0.014)。结论:凶险性前置胎盘的发生与此次妊娠距上次剖宫产间隔时间有关,间隔时间过短或过长,都会增加凶险性前置胎盘的发生。剖宫产手术1年以后5年以内再次妊娠低凶险性前置胎盘的发生率较低。

The Relationship between the Interval Time of Pregnancy and Last Cesarean Sectionand the Incidence of Pernicious Placenta Previa

Objective:To explore the relationship between the interval time of pregnancy and last cesarean section and the occurrence of pernicious placenta previa.Methods:The retrospective study reviewed clinical data of 548 women who delivered by caesarean section at Hebei General Hospital between April 1,2013,and May 31,2018.48 of the women were diagnosed with pernicious placenta previa.These women were divided into eleven groups based on interval time:from 0 to more than 10 years(every one year as a group).Results:There was statistically significant difference between the occurrence of pernicious placenta previa and interval time of next pregnancy from last cesarean section(P=0.000).There was statistical significance of four kinds of curve fitting models with Curve Regression Equation(P=0.000).The scatter plot showed that the incidence of pernicious placenta previa was higher when the interval between next pregnancy and cesarean section was less than 1 year and more than 5 years.According to the interval time,further comparisons were carried out(the time interval between<1 years and≥5 years as a group,1 years ≤ time interval<5 years as a group).The incidence of pernicious placenta previa was compared between the two groups.Chi-square test showed that there was significant difference between the two groups(P=0.014).Conclusions:The onset of pernicious placenta previa was related to the interval time between the pregnancy and the last cesarean section.The incidence of pernicious placenta previa increased when the interval time was too long or too short.The incidence was relatively lower if the next pregnancy occurred between one to five years after last cesarean section.