前置胎盘剖宫产子宫切口选择的临床研究

目的比较前置胎盘剖宫产子宫下段横切口和子宫下段纵切口对产时并发症、产后出血量及围产期结局的影响。方法以行子宫下段横切口剖宫产者为对照组(117例)，以子宫下段纵切口剖宫产术为研究组(142例)，分别记录两组研究对象剖宫产术时并发症、产时和产后24小时累计出血量、产后出血发生率及围产期结局。结果年龄、孕产次、孕周及前置胎盘类型和胎盘附着位置等有关因素比较无显著性(P＞0.05)。两组间的术时出血量、产后出血发生率、子宫切口撕裂发生率、宫腔填纱条和子宫切除率、围产期结局的比较差异十分显著(P＜0.01)。结论前置胎盘行子宫下段纵切口剖宫产术不仅可以减少术中出血量、产后出血率，而且避免子宫切口撕裂、宫腔填纱条和剖宫产术时子宫切除率也明显减少，是前置胎盘剖宫产结束妊娠的首选切口。

Clinical research ofsection choice in caesarean section for placenta praevia

Objective To investigate the influence of transverse and longitudinal lower segment caesarean section on the outcome of newborn, postpartum haemorrhage and ratio of complications in placenta previa. Methods Placenta previa with lower segment transverse caesarean section( 117 cases) were taken as control group, meanwhile, the lower segment with longitudinal section (142 cases ) as experimental group. Their operational complications, amount of bleeding during and after operation and outcome of the perinatal period were analysed. Results No significant difference in age, parities, gestational weeks, the types of the placenta praevia and the locus of placenta between the two groups were found( P>0.05), while there were significant difference in the amount of bleeding during and after operation, the need of using gauze ribbon to stop bleeding, section splitting and rate of hysterectomy after caesarean section(P<0.01). Conelusion Lower segment longitudinal caesarean section in placenta praevia not only shows less bleeding during operation and lower rate of postpartum haemorrhage, but also avoids using gauzes to stop bleeding and causes lower rate of hysterectomy after caesarean section, so it can be the first choice when determining the style of section in placenta praevia.