摘要
目的探讨前置胎盘合并胎盘植入的高危因素、诊断及治疗方法。方法对82例前置胎盘(前置胎盘组)和前置胎盘合并胎盘植入12例(胎盘植入组)孕产妇的临床资料进行回顾性分析。结果孕妇的年龄、孕次、前置胎盘类型及子宫手术史是发生胎盘植入的高危因素;胎盘植入组早产、新生儿窒息和产后出血的发生率均高于前置胎盘组(P<0.05);产前彩色多普勒超声诊断前置胎盘合并胎盘植入的正确率为83.3%(10/12),胎盘增厚、胎盘后方子宫壁肌层低回声带变薄(≤1 mm)或消失、胎盘实质内血流丰富、胎盘内腔隙是诊断前置胎盘合并胎盘植入的特征性声像图;治疗方法主要是积极的期待疗法及适时终止妊娠。结论孕妇年龄≥30岁、孕次≥3次、中央型前置胎盘及子宫手术史是前置胎盘合并胎盘植入的高危因素,彩色多普勒超声产前诊断胎盘植入是目前最简便可行的方法,采取个体化处理措施可改善母婴结局。
Objective To investigate the high risk factors,diagnosis and management of placenta previa combined with placenta accreta .Methods The clinical data of 12 cases of placenta previa combined with placenta accrete （ placenta accreta group ） and 82 cases of placenta previa （ placenta previa group ） were analyzed retrospective-ly.Results The age, gravidity, the types of placenta previa and uterine operation history were high risk factors of placenta accreta;The incidences of premature delivery , neonatal asphyxia and postpartum hemorrhage of placenta ac-creta group were higher than those of placenta previa group （ all P〈0.05 ）;The accuracy rate of prenatal color doppler ultrasound in the diagnosis of placenta previa with accreta was 83.3%（10/12）.Placenta thickening, the hypoecho of uterine wall muscle layer at the rear of placenta band of being thinning （≤1 mm） or disappeaing , placental parenchy-ma′s rich blood flow , placental cavity gap were characteristic sonogram of placenta previa combined with placenta ac -creta;Expectant treatment and timely termination of pregnancy were the main treatment methods .Conclusion Over 30 years of age ,pregnancy over three times , central type of placenta previa and uterine operation history are high risk factors.Color Doppler ultrasound is currently the most convenient method in diagnosis of placenta accreta .The indi-vidual treatment can improve maternal and neonatal outcomes .
出处
《中国临床新医学》
2014年第1期58-61,共4页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
关键词
前置胎盘
胎盘植入
高危因素
超声诊断
治疗方法
Placenta previa
Placenta accreta
High risk factors
Ultrasonic diagnosis
Treatment
