凶险性前置胎盘妊娠20例临床分析  

Clinical analysis of 20 pregnant cases with pernicious placenta previa

作　　者：刘金艳[1] 王艳丽[1] 石进[1] 唐俊[1] 

机构地区：[1]江苏省宿迁市泗洪县人民医院妇产科,江苏泗洪223900

出　　处：《中国当代医药》2015年第31期114-116,共3页China Modern Medicine

摘　　要：目的 探讨凶险性前置胎盘对妊娠结局的影响。方法 对2013年3月~2015年7月因凶险性前置胎盘在我院分娩的20份病例进行回顾性分析,了解凶险性前置胎盘对妊娠结局的影响。结果 20例中剖宫产终止妊娠者20例,其中发生产前出血10例,产后出血11例,术中行按摩子宫、卡前列甲酯栓口含、胎盘剥离出血面“8”字缝扎、宫腔纱布填塞、双侧子宫动脉结扎及B-lynch缝合等处理后子宫出血减少6例,5例前壁凶险性中央性前置胎盘因合并胎盘植入大出血行子宫切除,9例终止妊娠、孕周〈37周,12例新生儿转儿科诊治。结论 凶险性前置胎盘产前、产后出血率高、围生儿早产率高,前壁凶险型中央性前置胎盘易出现胎盘植入,子宫切除率高,需严格把握剖宫产指征,降低剖宫产率,以减少凶险性前置胎盘的发生。Objective To explore the influence of pernicious placenta previa on pregnancy outcomes. Methods From March 2013 to July 2015,20 medical cases with pernicious placenta previa delivered in our hospital were retrospective- ly analyzed in order to get known the influence of pernicious placenta previa on pregnancy outcomes. Results Among all these patients,20 cases with termination of pregnancy were through cesarean section.Ten cases of them occurred with antenatal bleeding,and postpartum hemorrhage was in 11 cases.6 cases of metrorrhagia was reduced by treatment such as massaging uterus during cesarean section,carboprost methylate suppositories holding in mouth,transfixion in ＂8＂ form in bleeding surface after placental separation,intrauterine gauze packing,bilateral uterine artery ligation,and B-lynch suturing,and so forth.Five cases were performed with hysterectomy in central pernicious placenta previa combined with placenta implantation.Gestational weeks were less than 37 weeks in 9 cases terminating pregnancy.There were 12 neonates transferred to pediatric department for treatment. Conclusion The rates of hemorrhage before and after birth, and rate of premature delivery in perinatal infants are all high in pernicious placenta previa.Especially when central pernicious placenta previa occurring with placenta implantation,it is in a high rate of hysterectomy.The indication of cesare- an section shall be strictly grasped to decrease the cesarean section rate and the occurrence of pernicious placenta previa.

关 键 词：凶险性前置胎盘 胎盘植入 瘢痕子宫 产后出血 

分 类 号：R714[医药卫生—妇产科学]