目的 探讨凶险型前置胎盘并发胎盘植入的高危因素及围产期处理.方法 回顾性分析188例凶险型前置胎盘患者的临床资料.结果 凶险型前置胎盘并发胎盘植入发生率为21.80%(41/188).凶险型前置胎盘并发胎盘植入的高危因素包括:孕妇高龄、流产次数≥2次、剖宫产2次.所有凶险型前置胎盘并发胎盘植入者均采用手术治疗,其中子宫切除率为26.82% (11/41),未并发胎盘植入者子宫切除率为0.96% (8/147),差异有统计学意义(χ2=16.141,P<0.01).结论 对高龄、有多次剖宫产史或多次流产史的凶险型前置胎盘患者应警惕并发胎盘植入,前置胎盘并发胎盘植入的子宫切除率增高.%Objective To investigate the high risk factors and perinatal management of pernicious placenta previa complicated with placenta accreta. Methods The data of 188 cases of patients with pernicious placenta previa was retrospectively analyzed. Results The incidence rate of pernicious placenta previa complicated with placenta accreta was 21. 8% ( 41/188 ), and the high risk factors of it included maternal advanced age, abortion frequency ≥2 and 2 times of cesarean section. All cases of pernicious placenta previa complicated with placenta accreta were treated by operation, and the uterus resection rate was 26. 82% ( 11/41 ). The uterus resection rate of cases without placenta accreta was 0. 96% ( 8/147 ). The difference was statistically significant (X2 = 16. 141, P < 0. 01 ). Conclusion Patients of pernicious placenta previa with advanced age, history of several times of cesarean section and abortion should alert complicated placenta accrete. The uterus resection rate increases for cases of placenta previa complicated with placenta accreta.
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