低置胎盘的分娩方式探讨

发布时间：2018-03-05 16:27

本文选题：低置胎盘　切入点：阴道分娩　出处：《现代妇产科进展》2015年02期 　论文类型：期刊论文

【摘要】：目的:探讨低置胎盘的合理分娩方式。方法:选取2012年1月1日至2014年4月30日在我院分娩的单胎头位低置胎盘产妇650例。按是否试产将患者分为试产组和选择性剖宫产组;按分娩前最后一次超声胎盘下缘距离宫颈内口的距离将患者分为低置胎盘1组(下缘距内口≥0mm但20mm)、低置胎盘2组(下缘距内口≥20mm但40mm)和低置胎盘3组(下缘距内口≥40mm但70mm)。分析患者的阴道试产成功率、试产失败原因、产后出血量及分娩期并发症。结果:(1)试产组的试产总成功率为82.64%,低置胎盘1、2、3组的阴道试产成功率分别为62.5%、82.61%和84.65%,其中因产前出血而改行剖宫产的风险分别为31.25%、8.7%和1.49%;(2)低置胎盘1组患者中阴道试产和选择性剖宫产的产后出血量无显著差异[(590.94±382.79)ml vs(465.68±367.83)ml];低置胎盘2组和3组中阴道试产的产后出血量明显少于剖宫产组[(267.17±104.47)ml vs(388.10±205.61)ml,P0.0001]及[(293.00±263.731)ml vs(348.59±98.68)ml,P0.0001]。结论:胎盘下缘距宫颈内口≥20mm不应作为孕妇选择性剖宫产的手术指征。
[Abstract]:Objective: To explore the reasonable mode of delivery of low placenta. Methods: from January 1, 2012 to April 30, 2014 in our hospital aboutsingletonnulliparousvertex head low placenta maternal 650 cases. According to whether the trial patients were divided into trial group and selective cesarean section group; according to the delivery before the last ultrasound placenta from the lower edge of the mouth of the cervix. The distance were divided into 1 groups (low placenta distance from the lower edge of mouth than 0mm but 20mm), group 2 (low placenta distance from the lower edge of mouth than 20mm but 40mm) and group 3 (low placenta distance from the lower edge of mouth than 40mm but 70mm) were analyzed. The success rate of vaginal delivery, the trial production failure reason, the amount of postpartum hemorrhage and childbirth complications. Results: (1) the pilot trial group the total success rate was 82.64%, the low success rate of placenta 1,2,3 group of vaginal delivery were 62.5%, 82.61% and 84.65%, which due to prenatal bleeding and diverted the risk of caesarean section were 31.25%, 8.7% and 1.49% (2) lower tyre; 1 groups of patients in the trial of vaginal disc and selective cesarean section postpartum hemorrhage had no significant difference between [(590.94 + 382.79) ml vs (465.68 + 367.83) was less than ml]; cesarean section group [bleeding placenta lower 2 group and 3 group of postpartum vaginal delivery (267.17 + 104.47 vs (ML) 388.10 + 205.61) ml, P0.0001] and [(293 + 263.731) ml vs (348.59 + 98.68) ml, P0.0001]. conclusion: placenta distance from the lower edge of the mouth of the cervix than 20mm pregnant women should not be used as selective cesarean section indications for surgery.

【作者单位】：同济大学附属第一妇婴保健院;
【分类号】：R714.4

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