前置胎盘伴疤痕子宫的母婴结局——附253例临床分析

发布时间：2018-03-31 03:42

本文选题：剖宫产　切入点：子宫切除　出处：《重庆医学》2015年07期

【摘要】：目的探讨不同类型的前置胎盘伴瘢痕子宫的母婴结局。方法对253例孕28~42周单胎不同类型的前置胎盘的母婴结局进行回顾性分析。母婴结局包括子宫切除率、产后出血率、新生儿Apgar评分和新生儿体质量,采用逻辑式回归分析。结果孕28~42周前置胎盘的发生率为5.54%,完全性39.92%,部分性35.57%,边缘性24.50%。疤痕子宫合并前置胎盘78例,发生率30.83%。253例中247例行剖宫产分娩,6例经阴道分娩占2.37%。10例因严重的产后出血行子宫切除,占3.95%,子宫切除中完全性前置胎盘9例占90.00%,子宫切除中10例均为瘢痕子宫并前置胎盘占100.00%,前置胎盘伴有剖宫产史2次或2次以上占行子宫切除的明显增高(P0.01)。排除孕龄因素,部分性和边缘性前置胎盘与完全性前置胎盘Apgar评分、新生儿体质量比较,差异无统计学意义(P0.05)。结论不同类型的前置胎盘中完全性前置胎盘伴瘢痕子宫增加了子宫切除的风险而对新生儿结局没有影响。
[Abstract]:Objective to study the outcome of different types of placenta previa with scar uterus.Methods the outcomes of 253 cases of placenta previa with different types of placenta previa were analyzed retrospectively.The maternal and infant outcomes included hysterectomy rate, postpartum hemorrhage rate, neonatal Apgar score and neonatal body mass. Logistic regression analysis was used.Results the incidence of placenta previa was 5.54, 39.92%, 35.57% and 24.50% respectively.78 cases of scar uterus combined with placenta previa, the incidence rate was 30.83.253 cases, 247 cases of cesarean section delivery 6 cases of vaginal delivery, 2.37% of 10 cases due to severe postpartum hemorrhage hysterectomy,9 cases of complete placenta previa in hysterectomy (90.00cm), 10 cases of hysterectomy with scar uterus and placenta previa (100.005%), and placenta previa with cesarean section (2 times or more) were significantly higher than that of hysterectomy (P 0.01).There was no significant difference in neonatal body mass between partial and marginal placenta previa and complete placenta previa Apgar score, excluding gestational age factors (P 0.05).Conclusion complete placenta previa with scar uterus in different types of placenta previa increases the risk of hysterectomy and has no effect on neonatal outcome.
【作者单位】：武汉大学人民医院产科;武汉大学公共卫生学院;
【基金】：湖北省自然基金资助项目(2012FFB04428)
【分类号】：R714.2

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