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目的:探讨晚期妊娠凶险型前置胎盘的临床特点,积累凶险型前置胎盘的临床处置经验。方法:通过对75例晚期妊娠凶险型前置胎盘病例进行回顾性分析,总结其对母婴造成的危害及应对措施。结果:38例有产前出血史,超声对凶险型前置胎盘诊断正确率可达100%,出血量超过500 ml有43例,发生率高达57.33%,其中除5例出血量≤600 ml未输血,其余病例全部输血,胎盘植入12例,子宫动脉介入栓塞8例,子宫切除3例,无死亡病例。结论:凶险型前置胎盘严重威胁母儿生命安全;严格掌握剖宫产指征、降低剖宫产率,是减少凶险型前置胎盘发生的关键环节;加强孕期监测、采取综合有效措施预防及抢救产后出血,最大限度改善妊娠结局。
Objective: To explore the clinical features of dangerous placenta previa in late pregnancy and to accumulate experience of clinical treatment of dangerous placenta previa. Methods: A retrospective analysis of 75 cases of threatened placenta previa in late pregnancy was conducted to summarize the harm caused to mothers and infants and the countermeasures. Results: 38 cases had a history of prenatal bleeding, the diagnosis of malignant placenta previa was 100%, 43 cases of bleeding more than 500 ml, the incidence was as high as 57.33%, except 5 cases of bleeding ≤ 600 ml Transfusion, the remaining cases of all blood transfusions, placenta accreta in 12 cases, 8 cases of uterine artery embolization, hysterectomy in 3 cases, no deaths. Conclusion: The threatening placenta previa placenta seriously threatens the life safety of mother and child. To strictly grasp the indication of cesarean section and reduce the rate of cesarean section is the key to reduce the risk of placenta previa. To strengthen the monitoring during pregnancy and take comprehensive and effective measures to prevent and Rescue postpartum hemorrhage, maximize pregnancy outcomes.