摘要
目的分析胎盘植入引起产后出血的危险因素和临床处理。方法回顾性分析孕晚期确诊胎盘植入72例孕妇的临床资料。其中,26例产后24h出血量≥1500ml(A组),46例<1500ml(B组),比较两组的一般资料和临床结局。结果流产史、产次、剖宫产史和合并前置胎盘是产后出血的危险因素(P<0.05)。A组中18例行保守治疗,如宫腔填塞纱条、子宫捆绑术、子宫动脉栓塞术止血成功,8例行子宫切除术。结论前置胎盘、瘢痕子宫并发胎盘植入极度凶险。对高度怀疑可能切除子宫的病例,可在术前行子宫动脉置管。
Objective To analyze the risk factors and management of severe postpartum hemorrhage caused by placenta accreta. Methods The data of 72 cases with a diagnosis of placenta accreta in the third trimester of pregnancy were retrospectively reviewed, of whom 26 cases（group A） after delivery had 24-hour bleeding amount of ≥1500 ml and 46 cases（group B） had that of 〈1500 ml. General conditions and clinical outcomes of two groups were compared. Results The abortion history, number of parturition, history of Cesarean section and placenta previa were the risk factors for severe postpartum hemorrhage（P〈0. 05）. Of 26 cases in group A, 18 cases received the conservative treatments such as uterine packing gauze, tied uterine surgery and uterine artery embolization for hemostasis, and 8 cases were conducted hysterectomy. Conclusion The pregnant women with placenta previa, scar uterine combined with placenta accreta are running high risk for severe postpartum hemorrhage. The uterine artery catheterization before Caesarean section is suggested in the patients highly doubted to have hysterectomy.
出处
《江苏医药》
CAS
2016年第16期1819-1821,共3页
Jiangsu Medical Journal
关键词
胎盘植入
前置胎盘
瘢痕子宫
产后出血
Placenta accreta
Placenta previa
Scar uterus
Postpartum hemorrhage
