Objective :To investigate the effect of different types of placenta previa on pregnancy outcomes . Methods :87 patients with placenta previa were selected as the observation group .The status of placenta previa was evaluated with ultrasonography ,intraoperative exploration and postpartum placenta examination ,and types included complete placenta previa ,partial placenta previa and marginal placenta previa .60 normal pregnant women were se-lected as control group .The risk factors of placenta previa pregnancy were analyzed and the maternal and infant out -come of the three groups were compared .Results :There was no significant difference between the observation group and the control group in age ,education level ,parity ,the incidence of diabetes and hypertension (all P > 0 .05) ,but the rates of smoking history ,pregnancy history ,cesarean section history ,history of abortion ,premature delivery history and anemia in the observation group were significantly lower than those in the control group (all P < 0 .05) . In 87 cases with placenta previa ,there were 22 cases with complete placenta previa ,27 cases with partial placenta previa and 38 cases with marginal placenta previa .The incidence rates of termination of pregnancy in the complete placenta previa group were significantly lower than other groups ,the placenta adherence ,placenta implantation ,ce-sarean section ,postpartum hemorrhage and hysterectomy in the complete placenta previa group were significantly higher than those in the partial placenta previa group and the marginal placenta previa group (all P< 0 .05) ,no sig-nificant differences between the partial placenta of pregnant woman with marginal groups placenta previa group (P>0 .05) .There were 3 cases of induced abortion and 1 case of neonatal death in the complete placenta previa group ,1 case of induced abortion in the partial placenta previa group .The other puerperae received prevention of miscarriage till 37 weeks .The incidence of premature birth and birth weight in the complete placenta previa group were signifi -cantly higher than those in the other two groups ,and the Apgar score was significantly lower than that in the other two groups (P< 0 .05) .Conclusion :Multiple abortion ,uterine curettage and smoking are risk factors of placenta previa ,and complete placenta previa can cause adverse maternal and neonatal outcomes .%目的:探讨不同类型胎盘前置状态对妊娠结局的影响.方法:收集前置胎盘患者87例作为观察组,根据超声检查 、术中探查 、产后胎盘检查等方法综合评估胎盘前置状态,分为完全性前置胎盘 、部分性前置胎盘 、边缘前置胎盘;另外同期选择60例产检正常孕妇为对照组.分析影响前置胎盘妊娠的危险因素,并比较三组患者母婴结局.结果:观察组与对照组年龄 、文化程度 、产次 、糖尿病 、高血压等发生率比较均无统计学差异(P均>0.05),但观察组吸烟史 、孕次 、剖宫产史 、流产史 、早产史 、贫血等发生率均显著低于对照组(P均<0.05);87例前置胎盘中,完全性前置胎盘 、部分性前置胎盘 、边缘前置胎盘依次有22例 、27例 、38例.完全性前置胎盘组的终止孕周显著低于对照组,胎盘粘连 、胎盘植入 、剖宫产 、产后出血及子宫切除率均显著高于部分性前置胎盘组 、边缘前置胎盘组(P均<0.05);部分性前置胎盘组孕妇分娩结局与边缘性前置胎盘组比较无统计学差异(P>0.05).完全性前置胎盘组3例引产 、1例新生儿期死亡,部分性前置胎盘组1例引产,其余产妇均顺利保胎至37周,且完全性前置胎盘组早产发生率 、出生体重均显著高于其他两组,Apgar评分显著低于其他两组,差异均具有统计学意义(P<0.05).结论:多次流产 、刮宫术 、吸烟等均是影响前置胎盘的危险因素,且完全性前置胎盘均可造成母婴不良结局.
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