前次剖宫产手术对再次妊娠胎盘植入及其类型的影响

发布时间：2018-12-15 01:58

【摘要】：目的:探讨前次剖宫产手术对再次妊娠胎盘植入及其类型的影响。方法:回顾性分析2012年1月至2016年12月在成都市妇女儿童中心医院分娩的11025例瘢痕子宫(前次剖宫产术)孕妇的临床资料,其中再次妊娠时1274例发生胎盘植入(粘连型905例,植入型309例,穿透型60例)。分析前次剖宫产是否伴发产后出血、前次剖宫产是否为产程中转急诊手术以及前次剖宫产距离本次妊娠时间与再次妊娠胎盘植入发生以及类型的关系。结果:(1)前次剖宫产伴发产后出血再次妊娠时胎盘植入总的发生率及3种类型的发生率均高于剖宫产后无产后出血组,差异有统计学意义(P0.05)。(2)前次剖宫产为产程中转急诊手术再次妊娠时胎盘植入总的发生率及3种类型的发生率均高于前次剖宫产为非产程中转手术,差异有统计学意义(P0.05)。(3)前次剖宫产距离本次妊娠的不同时间与再次妊娠时胎盘植入总的发生率及三种类型的发生率,差异无统计学意义(P0.05)。结论:前次剖宫产手术伴发产后出血、产程中转急诊剖宫产手术与再次妊娠时胎盘植入的发生可能有关,孕期应加强对这部分孕妇的管理。
[Abstract]:Objective: to investigate the effect of previous cesarean section on placenta accreta and its types. Methods: the clinical data of 11025 pregnant women with scar uterus (previous cesarean section) delivered in Chengdu Women and Children Central Hospital from January 2012 to December 2016 were retrospectively analyzed. 1274 cases of placenta accreta (905 cases of adherent type) were found in the second pregnancy. There were 309 cases of implantation type and 60 cases of penetrating type. To analyze whether the previous cesarean section is accompanied by postpartum hemorrhage, whether the previous cesarean section is a transitional stage of labor, and whether the time between the last cesarean section and the occurrence and type of placenta accreta of the second pregnancy. Results: (1) the total incidence of placenta accreta and the incidence of three types of placenta accreta in the previous cesarean section with postpartum hemorrhage were higher than those in the group without postpartum hemorrhage after cesarean section. The difference was statistically significant (P0.05). (2). The total incidence of placenta accreta and the incidence of three types of placenta accreta in the former cesarean section were higher than those in the previous cesarean section, and the incidence of three types of placenta accreta was higher than that in the previous caesarean section. The difference was statistically significant (P0.05). (3). The total incidence of placenta accreta and the incidence of three types of placenta accreta were not significantly different between the previous cesarean section and the second pregnancy (P0.05). Conclusion: the previous cesarean section with postpartum hemorrhage and the emergency caesarean section during labor may be related to the occurrence of placenta accreta during the second trimester. The management of these pregnant women should be strengthened during pregnancy.
【作者单位】：成都市妇女儿童中心医院;成都市第六人民医院;
【分类号】：R714.2

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