摘要
目的探讨瘢痕子宫合并中央性前置胎盘(CPP)的相关风险及处理措施。方法收集2012年12月至2013年12月来广饶县中医院终止妊娠的140例合并CPP产妇的临床资料,其中40例患者既往存在剖宫产史,作为观察组(瘢痕子宫合并CPP),100例患者无剖宫产史,作为对照组(非瘢痕子宫合并CPP)。观察并比较两组产妇的妊娠结局。结果观察组产妇产前、产后的出血量均明显多于对照组[418±164)m L比(274±93)m L、(1524±14)m L比(1033±10)m L](P<0.05);观察组剖宫产率、产后出血、胎盘粘连、胎盘植入的发生率分别为100.0%、40.0%、42.5%、20.0%,均高于对照组(80.0%,15.0%,18.0%,3.0%)(P<0.01);观察组早产、胎儿窘迫、新生儿窒息、围生儿死亡的发生率分别为55.0%、17.5%、25.0%、10.0%,显著高于对照组(30.0%,3.0%,8.0%,1.0%)(P<0.01)。观察组凶险型前置胎盘患者中有18例行子宫全切术,子宫保留率为55.0%(22/40),显著低于对照组的85.0%(85/100),差异有统计学意义(P<0.05)。结论瘢痕子宫合并CPP临床表现十分凶险,易发生胎盘植入、术后大出血等严重并发症,对母婴的生命安全威胁较大,应做好及时的产科抢救准备,并对产后出血采取积极的控制措施。
Objective To investigate the related risks of uterine scar combined with central placenta previa（ CPP） and the treatment measures. Methods Clinical data of 140 cases with maternal CPP to termi-nate the pregnancy in Guangrao County Hospital of Traditional Chinese Medicine from Dec. 2012 to Dec. 2013 were retrospectively analyzed,including 40 cases with pre-existing history of Cesarean section,as obser-vation group （ scar uterine combined with CPP） and 100 cases without history of Cesarean section,as control group （ non-uterine scar combined with CPP） . Maternal pregnancy outcomes in the two groups were observed and compared. Results The maternal prenatal,postpartum hemorrhage in the observation group were signifi-cantly more than the control group [ （ 418 ± 164 ） mL vs （ 274 ± 93 ） mL, （ 1524 ± 14 ） mL vs （ 1033 ± 10） mL] （P〈0. 05）;Cesarean rate,postpartum hemorrhage,placenta accreta,placenta implantation in the observation group were 100. 0%,40. 0%,42. 5%,20. 0% respectively,significantly higher than the control group（80. 0%,15. 0%,18. 0%,3. 0%）（P〈0. 01）; premature birth,fetal distress,neonatal asphyxia,peri-natal mortality rate in the observation group were 55. 0%,17. 5%,25. 0%,10. 0% respectively,significantly higher than the control group（30. 0%,3. 0%,8. 0%,1. 0%）（P 〈0. 01）. In the observation group, 10 cases of dangerous type of placenta previa received hysterectomy,the uterine retention rate was 55. 0%（22/40）,significantly lower than the control group′s 85. 0%（85/100）（P〈0. 05）. Conclusion The clinical per-formance of uterine scar combined with CPP is very dangerous,which may easily have serious complications of placenta accreta,postoperative bleeding threatening the lives of the mother and baby,therefore timely obstetric emergency preparations and postpartum hemorrhage control measures should be well prepared.
出处
《医学综述》
2015年第19期3605-3606,3613,共3页
Medical Recapitulate
关键词
瘢痕子宫
中央性前置胎盘
妊娠结局
肠道功能
Uterine scar
Central placenta previa
Pregnancy outcomes
Bowel function
