UAE联合利凡诺尔对胎盘前置状态引产结局及再次妊娠的影响  

Effect of uterine artery embolization combined with rivanol on the outcome of labor induction and re-pregnancy in women with placenta previa

作　　者：姚婷婷[1] 宁锋锋 苗丽娟[1] 刘青[3] 武美丽[1] 王晓霞[1] 孙礼[1] YAO Tingting;NING Fengfeng;MIAO Lijuan;LIU Qing;WU Meili;WANG Xiaoxia;SUN Li(Department of Reproductive Endocrinology,Gansu Provincial Maternity and Child-care Hospital,Lanzhou Gansu 730000,China;Department of Anesthesiology,Gansu Provincial Maternity and Child-care Hospital,Lanzhou Gansu 730000,China;Dean's Office,Gansu Provincial Maternity and Child-care Hospital,Lanzhou Gansu 730000,China)

机构地区：[1]甘肃省妇幼保健院生殖内分泌科,甘肃兰州730000 [2]甘肃省妇幼保健院麻醉科,甘肃兰州730000 [3]甘肃省妇幼保健院院长办,甘肃兰州730000

出　　处：《中国妇产科临床杂志》2024年第1期63-66,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：甘肃省科技厅甘肃省自然科学基金(21JR7RA657);兰州市科技发展指导性计划项目(2020-ZD-3)。

摘　　要：目的 探究子宫动脉栓塞术(UAE)联合利凡诺尔对胎盘前置状态引产结局及再次妊娠的影响。方法 回顾性分析2013年10月至2019年10月甘肃省妇幼保健院收治的180例胎盘前置状态引产患者的临床资料,将采用利凡诺尔引产的患者纳入对照组(n=105),采用UAE联合利凡诺尔引产的患者纳入病例组(n=75),比较两组的引产结局、生育能力、再次妊娠结局及新生儿不良结局。结果 病例组胎盘残留率、术后清宫率及失血量低于(少于)对照组,术后发热率高于对照组(P <0.05);病例组引产1个月后子宫内膜厚度小于对照组(P <0.05);对照组105例患者共45例患者再次妊娠,病例组75例患者中共32例再次妊娠,两组分娩方式、分娩孕周、妊娠间隔时间、产后出血量、胎盘植入比较差异均有统计学意义(P <0.05);病例组低体重儿数量多于对照组(P <0.05),其他指标比较差异均无统计学意义(P>0.05)。结论 UAE联合利凡诺尔可显著降低胎盘前置状态患者胎盘残留率、术后清宫率及失血量且不增加子宫切除、产后出血、宫腔感染及宫腔粘连情况,UAE治疗延长再次妊娠时间可能会改善不良结局和减少妊娠并发症。Objective To investigate the effect of uterine artery embolization(UAE) combined with Rivanol on the outcome of labor induction and re-pregnancy in women with placenta previa.Methods The clinical data of 180 women with placenta previa who underwent labor induction in Gansu Provincial Maternity and Child-care Hospital from October 2013 to October 2019 were analyzed retrospectively.Subjects treated with Rivanol were defined as the control group(n = 105),and those treated with UAE combined with Rivanol were defined as the case group(n = 75).The outcomes of labor induction,fertility,re-pregnancy outcomes and adverse neonatal outcomes were compared between the groups.Results The rate of placenta residue,postoperative uterine curettage and the blood loss in the case group were lower compared to the control group,while the rate of postoperative fever was higher than that in the control group(P < 0.05).One month after labor induction,endometrial thickness in the case group was thinner than that in the control group(P < 0.05).There were 45 cases of re-pregnancy in the control group and 32 cases of re-pregnancy in the case group.There were statistically significant differences between the two groups in terms of delivery mode,gestational week of delivery,interval between pregnancies,postpartum hemorrhage and placenta accreta(P < 0.05).There were more low birth weight infants in the case group than the control group(P < 0.05).The other indicators showed no statistically significant difference(P >0.05).Conclusions UAE combined with Rivanol can significantly reduce the rate of placenta residue,postoperative uterine curettage and the amount of blood loss in patients with placenta previa,without significantly increasing the rates of hysterectomy,postpartum hemorrhage,intrauterine infection and intrauterine adhesions.UAE prolongs the time to re-pregnancy,which may improve adverse outcomes and reduce pregnancy complications.

关 键 词：胎盘前置 引产 子宫动脉栓塞术 利凡诺尔 妊娠结局 

分 类 号：R719.3[医药卫生—妇产科学]