摘要
目的探讨前置胎盘孕妇产前出血影响因素及与妊娠结局的关系。方法回顾性分析2017年1月至2021年1月住院分娩的前置胎盘孕妇的资料,根据有无出现产前出血将孕妇分为出血组及无出血组,分析前置胎盘孕妇产前出血的影响因素;随访孕妇妊娠结局,分析产前出血与妊娠结局的关系。结果(1)宫腔操作次数、胎盘位置、前置胎盘类型及宫颈管长度、胎盘边缘厚度、胎盘边缘无回声区等超声指标与产前出血相关(P<0.05);多因素分析示,中央型前置胎盘、前壁胎盘是产前出血的独立危险因素,宫颈管长度小、胎盘边缘厚度大是产前出血的独立危险因素(P<0.05)。(2)出血组及非出血组产后出血、子宫切除情况比较差异无统计学意义(P>0.05);出血组新生儿体重、Apgar评分低于无出血组,新生儿窒息发生率高于无出血组(P<0.05)。(3)以新生儿体重、Apgar评分、新生儿窒息分别作为因变量,以临床资料作为自变量,在校正其他因素后,产前出血是前置胎盘不良妊娠结局发生的危险因素(P<0.05)。结论前置胎盘孕妇产前反复出血、大出血发生率较高,在临床中要积极做好产前出血风险的评估,提高围生儿结局。
Objective To investigate the influencing factors of prenatal hemorrhage in pregnant women with placenta previa and its correlation with pregnancy outcomes.Methods The clinical data about the pregnant women with placenta previa who delivered in our hospital from January 2017 to January 2021 were retrospectively analyzed.According to presence or absence of prenatal hemorrhage,the pregnant women were divided into hemorrhage group and non-hemorrhage group.The influencing factors of prenatal hemorrhage were analyzed.The pregnancy outcomes of pregnant women were followed up to analyze the correlation between prenatal hemorrhage and pregnancy outcomes.Results The frequency of uterine cavity operation,placenta sites,types of placenta previa and ultrasound indexes(length of cervical canal,thickness of placental edge,anechoic zone of placental edge)were closely related to prenatal hemorrhage(P<0.05).Multivariate analysis showed that central placenta previa,placenta anterior,short cervical canal length and thick placental edge were independent risk factors of prenatal hemorrhage(P<0.05).There were no significant differences in postpartum hemorrhage and hysterectomy status between hemorrhage group and non-hemorrhage group(P>0.05).Moreover the neonatal weight and Apgar scores in hemorrhage group were significantly lower than those in non-hemorrhage group(P<0.05),however,the incidence of neonatal asphyxia was significantly higher than that in non-hemorrhage group(P<0.05).In addition the neonatal weight,Apgar score and neonatal asphyxia were taken as dependent variables,and clinical data were taken as independent variables.After correcting the other factors,prenatal hemorrhage was a risk factor of adverse pregnancy outcomes in pregnant women with placenta previa(P<0.05).Conclusion The incidence of recurrent hemorrhage and massive haemorrhage is relatively higher in pregnant women with placenta previa,therefor,it is necessary to evaluate actively the risk of prenatal hemorrhage to improve perinatal outcomes in clinical practice.
作者
夏冉
李志芳
李青
XIA Ran;LI Zhifang;LI Qing(Department of Obstetrics and Gynecology,Anqing Municipal Hospital,Anhui,Anqing 246003,China)
出处
《河北医药》
CAS
2022年第11期1642-1645,共4页
Hebei Medical Journal
基金
安徽省重点研究与开发计划项目(编号:202104j07020022)。
关键词
前置胎盘
孕妇
产前出血
妊娠结局
placenta previa
pregnant woman
prenatal hemorrhage
pregnancy outcome
