143例凶险型前置胎盘发病的影响因素及围生期结局分析

摘要

目的 探讨凶险型前置胎盘发病的影响因素及围生期结局分析.方法 回顾分析2011年1月至2015年12月在百色市两所三甲医院住院分娩的143例凶险型前置胎盘孕产妇(研究组)和286例非凶险型前置胎盘孕产妇(对照组)的临床资料.结果 研究组孕产妇的平均年龄高于对照组(t=2.92,P=0.004);研究组孕产妇既往孕次、既往产次、既往流产次数、既往剖宫产次数、既往前置胎盘发生率均高于对照组(P＜0.01),研究组孕产妇的既往前置胎盘发生率高于对照组(x2=7.60,P=0.006);研究组孕产妇的产前孕周小于对照组(t=-12.33,P＜0.01).多因素分析显示,年龄、既往流产次数、既往剖宫产次是发生凶险型前置胎盘的影响因素,其中既往剖宫产次是3个影响因素中最主要的危险因素.研究组的产前出血发生率、产后出血发生率、子宫切除率、早产儿发生率均高于对照组(P＜0.01);研究组的术中出血量均高于对照组(P＜0.05);研究组的新生儿体质量和新生儿1 min Apgar评分等均低于对照组(P＜0.05).结论 年龄、既往流产次数、既往剖宫产次与凶险型前置胎盘的发生有关.%Objective To explore the influential factors of dangerous placenta previa pathogenesis,and to analyze their peri natal period outcomes.Methods The clinical data in 143 pregnant women and parturients of dangerous placenta previa(research group) and 286 pregnant women and parturients of non-dangerous placenta previa(control group) in our hospital from January 2011 to December 2015 were retrospectively analyzed.Results The average age of the research group was higher than that of the control group (t =2.92,P =0.004);the previous pregnancy frequency,previous parity,previous abortion frequency,previous cesarean delivery frequency and incidence of placenta previa in the research group were higher than those in the control group(P＜0.01);the incidence of placenta previa in the research group was higher than that in the control group(x2 =7.60,P=0.006);the prenatal gestational weeks of the research group were lower than those of the control group(t=-12.33,P＜0.01).The multi-factor analysis showed that the age,previous abortion frequency and previous cesarean delivery frequency were the influence factors of placenta previa occurrence.Among them,the previous cesarean delivery frequency was the main risk factor.The occurrence rates of antepartum hemorrhage,postpartum hemorrhage,uterine removal and premature infants in the research group were higher than those in the control group(P＜0.01);The intraoperative blood loss of the research group was higher than that of the control group(P＜0.05);the neonatal birth weight and the 1 min Apgar score of the research group were lower than those in the control group(P＜0.05).Conclusion The age,previous abortion frequency and previous cesarean section frequency are related to the occurrence of dangerous placenta previa.