凶险型前置胎盘妊娠38例临床分析  

Clinical analysis of 38 pregnant cases with pernicious placenta previa

作　　者：王马列[1] 梁润彩[1] 

机构地区：[1]中山大学附属第一医院妇产科,广州510080

出　　处：《新医学》2014年第9期617-621,共5页Journal of New Medicine

摘　　要：目的探讨凶险型前置胎盘的诊治及妊娠结局,提高对凶险型前置胎盘的认识水平,为临床上对凶险型前置胎盘母儿预后咨询提供依据。方法收集并分析38例凶险型前置胎盘及45例普通前置胎盘孕妇的临床资料,包括母体一般情况、产前超声检查、MRI检查、胎盘病理及母儿围生结局。结果凶险型前置胎盘组胎盘植入、子宫切除、产后出血、输血、产妇转ICU的发生率及出血量均较普通前置胎盘组明显升高(P均<0.05),新生儿胎龄小于36周比例、转新生儿ICU率及新生儿呼吸窘迫综合征发生率稍高于普通前置胎盘组,但比较差异无统计学意义(P均>0.05)。凶险型前置胎盘中非胎盘植入组与普通前置胎盘组母儿发病率比较差异无统计学意义(P>0.05)。结论凶险型前置胎盘易并发胎盘植入,子宫切除率高,孕产妇不良结局风险较普通前置胎盘增加,但围生儿不良结局风险无明显增加。Objective To investigate the diagnosis,treatment and pregnancy outcome of pernicious placenta previa and deepen the understanding of pernicious placenta previa,offering clinical evidence for such cases. Methods Clinical data of 38 cases with pernicious placenta previa and 45 cases with placenta previa were retrospectively analyzed,including general maternal state,ultrasonic and magnetic resonance imaging examinations,placental pathology and perinatal outcomes of both mother and fetus. Results The incidence of placenta accreta,hysterectomy,blood loss,postpartum hemorrhage,blood transfusion and maternal intensive care unit admissions in pernicious placenta previa group was significantly higher than those in placenta previa group（ all P〈0. 05）. The proportion of neonates with gestational age less than 36 weeks,NICU admissions,and neonatal respiratory distress syndrome in pernicious placenta previa group was higher than placenta previa group without a significant difference（ all P〉0. 05）. The incidence of maternal and perinatal morbidity between pernicious placenta previa without placenta accreta and placenta previa groups did not significantly differ（ P〉0.05）. Conclusions The incidence of placenta accrete and hysterectomy in pernicious placenta previa group was higher than that in placenta previa group. A higher risk of maternal adverse outcome was found in women with pernicious placenta previa. However,the risk of perinatal adverse outcome did not significantly increase.

关 键 词：前置胎盘 凶险型 胎盘植入 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]