疤痕子宫合并中央性前置胎盘的妊娠结局研究分析  

Study and Analysis on Pregnancy Outcome of Scarred Uterus Complicated with Central Placenta Previa

作　　者：吴丽珠 欧阳彦兰 

机构地区：[1]广东省惠州市第一妇幼保健院妇产科,广东惠州516000

出　　处：《临床医学工程》2018年第1期35-36,共2页Clinical Medicine & Engineering

基　　金：惠州市科技计划项目(项目编号:2016Y043)

摘　　要：目的分析疤痕子宫合并中央性前置胎盘的妊娠结局。方法选取我院2015年3月至2016年4月收治的中央性前置胎盘产妇90例,根据是否有剖宫产史分为疤痕子宫组和非疤痕子宫组,各45例。两组产妇均行剖宫产术。比较两组产妇产后2h、24 h出血量及围术期并发症、妊娠结局。结果疤痕子宫组产后2 h、24 h出血量均明显高于非疤痕子宫组(P<0.05)。疤痕子宫组的产后出血、先兆子宫破裂、胎盘植入及胎盘粘连发生率均明显高于非疤痕子宫组(P<0.05)。疤痕子宫组的早产、胎儿窘迫、新生儿窒息发生率及围产儿死亡率均明显高于非疤痕子宫组(P<0.05)。结论疤痕子宫合并中央性前置胎盘产妇分娩时具有出血量大及高并发症发生率的风险,且妊娠结局较差,严重威胁母婴生命安全。临床上应严格掌握剖宫产指征,高度重视孕早期诊断及监测,为及时抢救做好充分准备,改善母婴预后。Objective To analyze the pregnancy outcome of scarred uterus complicated with central placenta previa. Methods Ninety cases of puerperas with central placenta previa admitted to our hospital from March 2015 to April 2016 were selected and divided into scarred uterus group and non-scarred uterus group according to the cesarean section history, with 45 cases in each group. Both groups of puerperas received cesarean section. The postpartum 2 h and 24 h blood loss, complications during perioperative period and pregnancy outcomes were compared between the two groups. Results The postpartum 2 h and 24 h blood loss of the scarred uterus group were significantly higher than those of the non-scarred uterus group （P 〈0.05）. The incidences of postpartum hemorrhage, threatened uterine rupture, placenta implantation and placenta adhesion of the scarred uterus group were significantly higher than those of the non-scarred uterus group （P〈0.05）. The incidences of premature birth, fetal distress, neonatal asphyxia and perinatal mortality rate of the scarred uterus group were significantly higher than those of the non-scarred uterus group （P〈0.05）. Conclusions Puerperas with scarred uterus complicated with central placenta previa have risk of large amount of bleeding and high incidence of complications at birth, with poor pregnancy outcomes, which seriously threatens the safety of mothers and infants. Doctors should strictly control the cesarean section indications clinically, pay more attention to early pregnancy diagnosis and monitoring, and make full preparation for timely rescue, so as to improve the prognosis of mothers and infants.

关 键 词：疤痕子宫 中央性前置胎盘 并发症 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]