瘢痕子宫对中央性前置胎盘产妇围手术期并发症及妊娠结局的影响
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摘要
目的:观察瘢痕子宫对中央性前置胎盘(CPP)产妇围手术期并发症及妊娠结局的影响。方法:回顾性分析2015年1月至2017年6月154例CPP产妇的临床资料,根据是否存在瘢痕子宫分为观察组(合并瘢痕子宫)51例和对照组(无瘢痕子宫)103例。比较两组产后2 h、24 h出血量、并发症发生率、子宫切除率、剖宫产率、死亡率和围产儿临床结局。结果:观察组产后2 h、24 h出血量均明显高于对照组,胎盘植入、胎盘黏连、产后出血、先兆子宫破裂发生率、子宫切除率、剖宫产率、围产儿胎儿窘迫、早产和新生儿窒息发生率均明显高于对照组,差异有统计学意义(P<0.05)。结论:瘢痕子宫可增加中央性前置胎盘产妇围手术期并发症发生率,并严重威胁妊娠结局。
Objective: To observe effects of scar uterus on perioperative complications and pregnancy outcomes in central placenta previa(CPP) parturient women. Methods: The clinical data of 154 women with CPP were retrospectively analyzed. According to the presence or absenceof scar uterus, they were divided into observation group(51 cases, with scar uterus) and control group(103 cases, without scar uterus). The 2 h and24 h postpartum hemorrhage, complication rate, hysterectomy rate, cesarean section rate, mortality, and perinatal clinical outcomes were comparedbetween the two groups. Results: The 2 h and 24 h postpartum hemorrhage of the observation group were significantly higher than those of the controlgroup; the rates of placenta implantation, placental adhesion and postpartum hemorrhage, the incidence of threatened uterine rupture, hysterectomyrate, cesarean section rate, and the incidences of perinatal fetal distress, premature birth and neonatal asphyxia were significantly higher than thoseof the control group; and the differences were statistically significant(P<0.05). Conclusions: Scar uterus can increase the incidence of perioperativecomplications in the CPP women, and seriously threaten the pregnancy outcomes.
Objective: To observe effects of scar uterus on perioperative complications and pregnancy outcomes in central placenta previa(CPP) parturient women. Methods: The clinical data of 154 women with CPP were retrospectively analyzed. According to the presence or absenceof scar uterus, they were divided into observation group(51 cases, with scar uterus) and control group(103 cases, without scar uterus). The 2 h and24 h postpartum hemorrhage, complication rate, hysterectomy rate, cesarean section rate, mortality, and perinatal clinical outcomes were comparedbetween the two groups. Results: The 2 h and 24 h postpartum hemorrhage of the observation group were significantly higher than those of the controlgroup; the rates of placenta implantation, placental adhesion and postpartum hemorrhage, the incidence of threatened uterine rupture, hysterectomyrate, cesarean section rate, and the incidences of perinatal fetal distress, premature birth and neonatal asphyxia were significantly higher than thoseof the control group; and the differences were statistically significant(P<0.05). Conclusions: Scar uterus can increase the incidence of perioperativecomplications in the CPP women, and seriously threaten the pregnancy outcomes.
引文
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[12]谭白菊,李玉梅,冯小平.卡前列素氨丁三醇联合葡萄糖酸钙防治瘢痕子宫合并前置胎盘再次剖宫产产后出血的研究[J].中国妇幼健康研究,2017,28(5):553-555.
[2]方有珍.瘢痕子宫合并前置胎盘的分娩结局分析[J].西南军医,2014,16(2):155-156.
[3]谢幸,苟文丽.妇产科学[M].北京:人民卫生出版社,2014:127.
[4]Lumbiganon P,Laopaiboon M,Gülmezoglu AM,et al. Methodof delivery and pregnancy outcomes in Asia:the WHO global surveyon maternal and perinatal health 2007-08[J]. Lancet,2010,375(9713):490-499.
[5]王进,朱玉香.瘢痕子宫再次妊娠剖宫产对母婴影响及并发症分析[J].中国妇幼健康研究,2015,26(2):304-306.
[6]赵伟雪,秦彩云.瘢痕子宫合并前置胎盘再次剖宫产对围生儿及产妇的危险性分析[J].实用妇科内分泌电子杂志,2014,1(5):13-15.
[7]熊钰,李笑天.瘢痕子宫产生的常见原因及其对远期妊娠的影响[J].中国实用妇科与产科杂志,2010,14(8):577-579.
[8]郑丹梅,张秋梅.瘢痕子宫合并前置胎盘的临床特点与影响分析[J].世界临床医学,2017,11(2):136.
[9]韩朝霞.瘢痕子宫前置胎盘47例行剖宫产术的临床分析[J].基层医学论坛,2016,20(27):3889-3890.
[10]颜彬.瘢痕子宫合并前置胎盘对母婴妊娠结局的影响[J].现代诊断与治疗,2015,26(24):5713-5714
[11]王萍,孟凡秀.前置胎盘(中央型)合并瘢痕子宫术中出血治疗体会[J].实用妇科内分泌电子杂志,2016,3(12):133-135.
[12]谭白菊,李玉梅,冯小平.卡前列素氨丁三醇联合葡萄糖酸钙防治瘢痕子宫合并前置胎盘再次剖宫产产后出血的研究[J].中国妇幼健康研究,2017,28(5):553-555.