凶险型前置胎盘107例临床分析

发布时间：2018-04-12 06:59

本文选题：凶险型前置胎盘 + 危险因素　；参考：《现代妇产科进展》2015年08期

【摘要】：目的:探讨凶险型前置胎盘(PPP)发病的危险因素、临床特点及围生期结局。方法:随访并回顾分析2012年3月至2014年3月于江西省妇幼保健院分娩的107例PPP孕妇和非前置胎盘剖宫产史孕妇321例的临床资料。结果:我院的PPP发生率为0.354%。107例PPP孕妇中,中央性前置胎盘占60.7%,部分性前置胎盘占30%,边缘性前置胎盘占9.3%。胎盘植入39例,胎盘植入发生率为0.123%。单因素分析显示,两组孕妇的年龄、孕次、产次、流产史、居住地、剖宫产史、既往剖宫产医院为三级医院、分娩前经历产程比较,差异均有统计学意义(P0.05)。多因素分析示,年龄、流产史、产次、剖宫产史为PPP发病的高危因素。居住地为城市、既往行剖宫产的医院为三级医院、前次剖宫产前经历产程可降低PPP发生的风险。PPP易发生胎盘植入、产后出血、增加输血、子宫切除等风险,延长分娩后住院时间。PPP孕妇分娩的围生儿体重、胎龄均低于对照组,有较高的早产率(57.0%)、新生儿窒息率(14.0%),增加了围生儿死亡的风险。结论:高龄、多次流产、多产次、多次剖宫产史是凶险型前置胎盘的独立危险因素,而既往行剖宫产的医院为三级医院、前次剖宫产前经历产程、居住于城市可降低PPP发生的风险。
[Abstract]:Objective: to investigate the risk factors, clinical characteristics and perinatal outcome of dangerous placenta previa previa.Methods: the clinical data of 107 pregnant women with PPP and 321 pregnant women with history of cesarean section without placenta previa were analyzed retrospectively from March 2012 to March 2014 in Jiangxi Maternal and Child Health Hospital.Results: the incidence of PPP in our hospital was 0.354%. 107 cases of PPP pregnant women, the central placenta previa accounted for 60.7%, partial placenta previa accounted for 30 cases, marginal placenta previa accounted for 9.3%.There were 39 cases of placenta accreta, the incidence of placenta accreta was 0.123%.Univariate analysis showed that the two groups of pregnant women's age, pregnancy, labor, abortion history, residence, cesarean section history, the past cesarean section hospital is a third-class hospital, the difference before delivery, the difference was statistically significant (P 0.05).Multivariate analysis showed that age, history of abortion, time of delivery and history of cesarean section were high risk factors for PPP.The place of residence is a city, the hospital that used to perform cesarean section is a third class hospital. The risk of placenta accretion, postpartum hemorrhage, blood transfusion, hysterectomy and so on can be reduced by the previous cesarean section, which can reduce the risk of placenta accretion, postpartum hemorrhage, blood transfusion, hysterectomy and so on.The perinatal weight and gestational age of PPP pregnant women were lower than those of the control group. The premature delivery rate was 57.0% and the neonatal asphyxia rate was 14.0%, which increased the risk of perinatal death.Conclusion: old age, multiple miscarriages, multiple cesarean sections and multiple cesarean sections are independent risk factors for the dangerous placenta previa.Living in a city reduces the risk of PPP.
【作者单位】：江西省妇幼保健院;
【基金】：国家科技支撑计划(No:2014BA105B02)
【分类号】：R714.5

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