前置胎盘的特点及其对母儿妊娠结局的影响的分析研究  

Characteristics of Placenta Previa and the Study of Its Influences on Pregnancy Outcomes

作　　者：杨贺勤[1] 王清[1] 周莲娥[1] 王世军[1] Yang Heqin;Wang Qing;Zhou Lian′e(Department of Obstetrics and Gynecology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院,北京100053

出　　处：《医学研究杂志》2020年第6期165-170,共6页Journal of Medical Research

摘　　要：目的分析总结前置胎盘特点及其对妊娠结局的影响,为前置胎盘患者的诊治提供参考。方法选取2016年1月1日~2018年12月31日于笔者医院分娩的前置胎盘患者155例,将其分为4组,即低置胎盘组(56例)、边缘性前置胎盘组(22例)、部分性前置胎盘组(17例)和完全性前置胎盘组(60例)。选取同时期正常产妇50例作为对照组,对各组患者的临床表现、妊娠结局及新生儿情况进行比较分析。结果前置胎盘组患者存在产前阴道出血,胎盘位置与宫颈内口越接近,出血时间越早、出血人数越多、出血量越大(P<0.05)。与对照组比较,各前置胎盘组剖宫产率高,胎盘粘连、胎盘植入、产后出血、输血、子宫切除、贫血及休克的发生率高,住院时间长(P均<0.05)。而5组患者弥散性血管内凝血的发生率比较,差异无统计学意义(P>0.05)。与对照组比较,前置胎盘组早产发生率高,新生儿出生体重低(P<0.05);而5组间1min、5min阿氏评分以及窒息的发生率比较,差异无统计学意义(P>0.05)。结论前置胎盘尤其是完全性前置胎盘患者可致剖宫产率高,产时及产后并发症发生率增高,影响新生儿质量,临床上应给与充分重视、积极治疗。Objective To provide reference in dealing with placenta previa patients in clinical work.Methods Totally 155 patients with placenta previa delivered in our hospital from January 1,2016 to December 31,2018 were collected as research subjects.They were divided into group of low lying placenta(56 cases),group of marginal placenta previa(22 cases),group of partial placenta previa(17 cases)and group of complete placenta previa(60 cases).50 patients without placenta previa were selected as control group during the same period.The general characteristics,prenatal hemorrhage,pregnancy outcomes and newborns of the 5 groups were observed and compared.Results There was antepartum vaginal bleeding in patients with placenta previa.The closer the placenta was to the cervix,the earlier the bleeding time,the higher the bleeding ratio and the larger the bleeding volume(P<0.05).Compared with the control group,patients in placenta previa groups had increased cesarean section rate,higher incidences of placenta adhesion,placenta implantation,postpartum hemorrhage,blood transfusion,hysterectomy,anemia,hemorrhagic shock as well as longer hospital stay(P<0.05).However,there was no difference in the incidence of disseminated intravascular coagulation among 5 groups(P>0.05).The incidence of premature labor was higher and the birthweight was lower in placenta previa groups compared with the control group(P<0.05).However,there was no difference in Apgar scores at 1 and 5 minutes and the incidence of asphyxia among the 5 groups(P>0.05).Conclusion Antepartum hemorrhage is the typical clinical manifestation of placenta previa.Placenta previa,especially complete placenta previa,can lead to high cesarean section rate and the increased incidence of complications during delivery and postpartum,as well as affect the quality of newborn.Therefore,full attention should be given to the patients with placenta previa.Moreover,appropriate treatments should be taken in time to reduce both maternal and neonatal complications.

关 键 词：前置胎盘 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]