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目的探讨凶险型前置胎盘发病的相关因素及妊娠结局。方法回顾性分析2010年5月-2016年5月江油市人民医院12 000例分娩产妇的临床资料,其中凶险型前置胎盘28例(研究组)、普通前置胎盘323例(普通组),另选择同期有剖宫产史的健康产妇300例作为对照组,采用Logistic回归分析影响凶险型前置胎盘的相关因素,并比较不同组的妊娠结局。结果凶险型前置胎盘发生率为0.23%(28/12 000),Logistic回归分析显示孕次≥3次、产次≥2次、流产次≥2次、剖宫产次≥2次是凶险型前置胎盘的危险因素;研究组产后出血、胎盘植入、子宫切除、胎盘粘连发生率为53.57%、57.14%、14.29%、17.86%,均高于普通组和对照组(P<0.05)。结论凶险型前置胎盘的影响因素有孕次、产次、流产次、剖宫产次数,同时产妇易并发产后出血、胎盘植入、胎盘粘连,会增加子宫切除率,临床应对其引起高度重视。
Objective To investigate the related factors of morbid placenta previa and pregnancy outcome. Methods The clinical data of 12 000 mothers giving birth in Jiangyou People’s Hospital from May 2010 to May 2016 were retrospectively analyzed. Among them, 28 cases of dangerous placenta previa (study group), 323 cases of common placenta previa (normal group) Another 300 pregnant women with the history of cesarean section were chosen as the control group. Logistic regression analysis was used to analyze the influencing factors of the risky placenta previa and to compare the pregnancy outcomes of different groups. Results The incidence of threatened placenta previa was 0.23% (28/12 000). Logistic regression analysis showed that the number of pregnancies was ≥3 times, the number of births was ≥2 times, the number of miscarriage was ≥2 times, and the number of cesarean births ≥2 times was dangerous The risk factors of placenta previa were 53.57%, 57.14%, 14.29% and 17.86% respectively. The incidence of postpartum hemorrhage, placenta accreta, hysterectomy and placenta accreta in study group were higher than those in normal group and control group (P <0.05). Conclusions The influencing factors of threatening placenta previa are pregnancy times, delivery times, miscarriage times, the number of cesarean delivery, simultaneous maternal postpartum hemorrhage, placenta accreta and placenta accreta. It will increase the hysterectomy rate and pay more attention to the clinical response .