凶险性前置胎盘的产前预测及临床处理

发布时间：2018-03-04 07:35

本文选题：凶险性前置胎盘　切入点：胎盘粘连　出处：《中国妇产科临床杂志》2015年05期 　论文类型：期刊论文

【摘要】：目的探讨凶险性前置胎盘的产前预测及临床处理,为改善母儿结局、预防产后出血提供依据。方法回顾性分析2011年1月1日至2014年11月30日内蒙古赤峰市医院收治的34例凶险性前置胎盘患者的临床资料。结果 34例患者术前彩超提示18例有胎盘植入或胎盘粘连的特征性图像,16例未见特征性图像,术中证实34例患者中有16例合并胎盘植入,18例伴有不同程度胎盘粘连。34例凶险性前置胎盘患者中有6例行全子宫切除术,其余均保留子宫。26例围生儿结局良好,2例围生儿死亡,6例新生儿窒息转NICU观察治疗。结论凶险性前置胎盘常出现不可预见和无法控制的产前、产时和产后大出血,增加了子宫切除的概率。因此,对存在高危因素的孕妇加强孕期检查,结合彩色多普勒超声检查对凶险性前置胎盘进行合理预测,重视围术期处理、术中子宫缝合止血技术的有效选择可以明显降低子宫切除率,改善围生儿结局。
[Abstract]:Objective to investigate the prenatal prediction and clinical management of dangerous placenta previa in order to improve the maternal and fetal outcome. Methods from January 1st 2011 to November 30th 2014, 34 patients with dangerous placenta previa were analyzed retrospectively. Results 34 patients were diagnosed by color Doppler ultrasonography before operation. It was suggested that 18 cases with placenta accreta or placenta adhesion had no characteristic images in 16 cases. 16 of 34 patients with placenta accreta were associated with placental adhesions of varying degrees. 6 of 34 patients with dangerous placenta previa underwent hysterectomy. The rest of the 26 cases of perinatal pregnancy had a good outcome and 2 cases of perinatal death and 6 cases of neonatal asphyxia were transferred to NICU observation treatment. Conclusion the dangerous placenta previa often has unpredictable and uncontrollable haemorrhage before delivery and postpartum. Therefore, pregnant women with high risk factors should be examined during pregnancy, combined with color Doppler ultrasonography to predict the risk of placenta previa reasonably, and pay attention to perioperative management. The effective choice of intraoperative uterine suture hemostasis can significantly reduce the rate of hysterectomy and improve the perinatal outcome.
【作者单位】：内蒙古赤峰市医院;
【分类号】：R719.8

【共引文献】