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目的分析凶险型前置胎盘的临床表现及对孕产妇的危害,探讨终止妊娠时机、处理方法及预防措施。方法将2008—2012年福建省妇幼保健院产科住院分娩的37例凶险型前置胎盘设为病例组,另随机选取同期前置胎盘且胎盘附着于子宫前壁下段的35例做为对照组,比较两组年龄、孕周、孕、产次、产后出血量、手术方式、胎盘植入、新生儿情况等指标。结果病例组产后出血量平均2 000mL以上,子宫切除7例(18.9%)、胎盘植入11例(29.7%)、输血26例(70.3%),均高于对照组(平均出血量<2 000mL,无子宫切除,胎盘植入1例,输血9例);两组新生儿体重、新生儿窒息和早产儿占比均类似。结论凶险型前置胎盘病情凶险,产后出血多,子宫切除比例高,对孕产妇造成极大危害。降低剖宫产率是减少凶险型前置胎盘发生的根本措施。
Objective To analyze the clinical manifestations of dangerous placenta previa and maternal harm, explore the timing of termination of pregnancy, treatment and preventive measures. Methods From March 2012 to March 2012, 37 cases of dangerous placenta previa delivered in obstetrics and gynecology hospital of Fujian Provincial Maternal and Child Health Hospital were enrolled as case group. Another 35 cases of placenta accreta placenta accreta were randomly selected as the control group, Comparison of two groups of age, gestational age, pregnancy, births, postpartum hemorrhage, surgical methods, placenta accreta, neonatal conditions and other indicators. Results The average amount of postpartum hemorrhage was more than 2 000 mL in case group, 7 cases (18.9%) in hysterectomy, 11 cases (29.7%) in placenta accreta, and 26 cases (70.3%) in transfusion group were higher than those in control group , No hysterectomy, 1 case of placenta accreta, 9 cases of blood transfusion). The birth weight, neonatal asphyxia and proportion of preterm infants in both groups were similar. Conclusion The risky placenta previa is dangerous, with more postpartum hemorrhage and higher rates of hysterectomy, which cause great harm to pregnant women. Reduce cesarean section rate is to reduce the incidence of dangerous placenta previa.