胎盘位置影响胎盘早剥的妊娠结局分析  

Influence of Pregnancy Outcome about Placental Position on Placental Abruption

作　　者：陈汉青[1] 邹粟花[1] 蔡坚[1] 张颖[1] 杨建波[1] 王子莲[1] 

机构地区：[1]中山大学附属第一医院妇产科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2016年第1期91-94,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2012B031800384)

摘　　要：【目的】分析胎盘附着位置对胎盘早剥母儿结局的影响。【方法】回顾性分析我院分娩的51例胎盘早剥病例。胎盘附着于子宫前壁者20例(前壁组),附着于子宫后壁者31例(后壁组)。【结果】51例均行剖宫产分娩。前壁胎盘组的产前出血发生率高于后壁胎盘组(80.0%vs 19.4%,P<0.001);其分娩前诊断的比例明显高于后壁胎盘组(90.0%vs 45.2%,P=0.001)。而后壁胎盘组的产后出血量显著多于前壁胎盘组[(818.7±498.6)m L vs(400.0±132.5)m L,P=0.001],后壁胎盘组需要输血的发生率也高于前壁胎盘组(38.7%vs 10.0%,P=0.025)。后壁胎盘组新生儿窒息的发生率显著高于前壁胎盘组(41.9%vs 10.0%,P=0.015)。两组患者的发病诱因、分娩孕周、产后出血率、DIC发生率、新生儿出生体质量、胎儿宫内窘迫发生率等无显著差异(P>0.05)。【结论】后壁胎盘的胎盘早剥病例临床症状不明显,诊断困难,易致严重并发症,危及母儿生命。出现胎监反应欠佳及胎儿宫内窘迫等异常且原因不明时,应考虑胎盘早剥可能,及时处理以降低母儿并发症。【Objective】 To analyze the influence of placental position on pregnancy outcome of placental abruption. 【Methods】We retrospectively analyzed 51 cases of placental abruption who dilveried in our hospital. There are 20 cases in which the placenta was implanted on the anterior wall of the uterus（anterior group）, and 31 cases was implanted on the posterior（posterior group）.【Results】 All cases underwent cesarean section. The incidence of antenatal hemorrhage in the anterior group was higher than that in the posterior group（80.0% vs 19.4%, P〈0.001）; Also the diagnosis rate before delivery of the anterior group was higher than that of the posterior group（90.0% vs 45.2%,P = 0.001）. But the volume of postpartum hemorrhage in the posterior group was more than that of the anterior group（818.7 ± 498.6 m L vs 400.0 ± 132.5 m L,P = 0.001）, and the transfusion proportion of the posterior group was higher than that of the anterior group（38.7% vs 10.0%,P = 0.025）. The incidence of neonatal asphyxia in the posterior group was higher than that in the anterior group（41.9% vs 10.0%,P = 0.015）. There were no differences between the two groups in the cause of the disease, incidence of postpartum hemorrhage, occurrence of DIC, birth weight, proportion of fetal distress（P〉0.05）.【Conclusion】 Clinical symptoms of posterior placental abruption are not obvious. It is difficult to diagnosis before delivery, which prone to cause serious complications. When there is unexplained poor response of fetal monitoring and fetal distress, placental abruption should be considered. Then it should be timely treated to reduce the complications of mothers and infants.

关 键 词：胎盘早剥 胎盘位置 结局 

分 类 号：R71[医药卫生—妇产科学]