对前置胎盘孕妇实施期待治疗的临床研究

目的观察对前置胎盘孕妇实施期待治疗的临床疗效。方法对2006年1月至2010年1月珠海市人民医院收治前置胎盘患者50例孕妇实施期待法:卧床休息;保持精神安静,适当给予镇静剂;静脉输液补充复方氨基酸、葡萄糖及维生素C等;必要时输血;静脉滴注硫酸镁或口腹硫酸沙丁胺醇;肌内注射地塞米松促胎肺成熟;预防应用抗生素。结果终止妊娠时孕32+6～36+2周,平均(34.78±0.69)周,平均延长(1.59±0.23)周;产后出血平均180～460mL,平均(280.56±29.89)mL,产褥感染2例;新生儿1、5minApgar评分平均(8.12±0.45)、(9.06±0.51)分;新生儿呼吸窘迫综合征3例、死亡2例。结论对前置胎盘孕妇实施期待治疗可以孕周延长、减少产后出血少及产褥感染、新生儿Apgar正常、RDS及死亡低,具有可行性,但在实施中应该注意与患者进行充分沟通、准确判断对胎儿成熟度、选择合适的分娩方式。

Clinical Research of Expectant Treatment about Pregnant Women with Placenta Previa

Objective To Observe the clinical efficacy of expectant treatment about pregnant women with placenta previa. Method From January 2006 to January 2001 in Zhuhai people＇s hospital, 50 cases of pregnant women with placenta previa treated by expectant treatment： bed rest; to maintain the spirit of quiet, appropriate to give sedatives; intravenous fluid replacement compound of amino acids, glucose and vitamin C, etc.; when necessary, blood transfusion; intravenous infusion of magnesium sulfate, or avoid unnecessary salbutamol; intramuscular injection of dexamethasone to promote fetal lung maturation; preventive antibiotics. Results Termination of pregnancy when the pregnant 32＋6~36＋2 weeks, with an average （34.78± 0.69） weeks, with an average extension of （1.59±0.23） weeks; postpartum hemorrhage on average 180~460mL, Mean （280.56±29.89） mL, puerperal infection in 2 cases; newborn 1min, 5min Apgar score was （8.12±0.45）, （9.06±0.51）; neonatal respiratory distress syndrome in 3 cases, 2 deaths. Conclusions Expectant treatment about pregnant women with placenta previa can be extended weeks of gestation, and to reduce postpartum hemorrhage and puerperal infection in a small, newborn Apgar normal, RDS and death is low, with the feasibility, but the implementation should pay attention to fully communicate with patients, accurately to determine fetal maturity, select the appropriate mode of delivery.