92例前置胎盘的高危因素及围生儿结局观察  

Observation of high risk factors of placenta previa and neonatal outcome in 92 cases

作　　者：何红芬[1] 李红[1] 刘欣婕 

机构地区：[1]云南省曲靖市第一人民医院妇产科,655000

出　　处：《检验医学与临床》2013年第7期805-807,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨前置胎盘发生的高危因素及其对妊娠结局的不良影响。方法回顾性分析9年间分娩的92例单胎前置胎盘病例(前置胎盘组)和186例单胎非前置胎盘对照产妇(对照组)的临床资料。结果前置胎盘发生率为0.93%(92/9 620)。前置胎盘组产妇年龄大于对照组(≥35岁,OR=8.75,P<0.01),胎次(≥3次,OR=5.70,P<0.01)产次(≥2次,OR=6.77,P<0.01)、流产次数(≥3次,OR=7.03,P<0.01)、前次剖宫产史(P<0.01)均多于对照组。前置胎盘组新生儿早产发生率高于对照组(47.83%比7.07%,P<0.01),早产儿1min Ap-gar评分低于对照组[(7.04±2.06)分比(9.09±0.81)分,P<0.01],新生儿出生体质量低于对照组(P<0.01);两组新生儿出生性别的差异无统计学意义。结论高龄(≥35岁)、多产(≥2次)、多胎(≥3次)、多次流产(≥3次)及前次剖宫产史的孕妇前置胎盘发生率高,且易导致早产和新生儿窒息,是产前重点监护的对象。Objective To evaluate the high risk factors of placenta previa and the adverse effect of pregnancy outcome. Methods From March 2002 to April 2011, retrospective case-control study was carried out in included a to- tal of 92 singlet pregnancies with placenta previa and 184 non-placenta previa singlet pregnancies as controls. Results The incidence of placenta previa was 0.93%. Factors significantly associated with development of placenta previa were advanced maternal age （≥35 years, OR = 8. 75, P 〈0. 01 ）, gravidity of 3 times and more （OR = 5.70, P 0.01） ,more than one previous delivery （OR=6.77,P〈0.01） ,abortions （≥3,0R=7.03,P〈0. 01） ,history of previous cesarean section （P〈0. 01）. The main perinatal complication was preterm birth （47. 83% vs 7.07%, P〈0.01） ,and preterm infants of mothers with placenta previa were more likely to have lower first minute Apgar scores （7.04±2.06 vs. 9.09± 0.81 ） （P〈0.01 ）. Infants of mothers with placenta previa had significantly lower birth weight than that of controls （P〈0.01）. No difference was found between the groups concerning about sex at birth. Conclusion The high risk factors of placenta previa are advanced maternal age,gravidity of 3 times or more,more than one previous delivery,abortions and history of previous cesarean section. The main problems in pregnancies with placenta previa are premature delivery and neonatal asphyxia. Careful antepartum monitoring of these high-risk preg- nancies is of utmost importance.

关 键 词：前置胎盘 高危因素 围生儿结局 

分 类 号：R714.462[医药卫生—妇产科学]