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目的:探讨凶险型前置胎盘的临床特点,预防产后出血发生率,降低严重产后出血和子宫切除的风险,提高围生儿的存活率,降低孕产妇死亡率。方法:对43例凶险型前置胎盘中的中央型组与非中央型组孕产妇妊娠结局进行回顾性分析。结果:中央型组与非中央型组严重产后出血率、胎盘植入率、DIC发生率、子宫切除率比较差异有统计学意义(P<0.05),而两组围产儿结局差异无统计学意义(P>0.05)。结论:中央型凶险型前置胎盘比非中央型凶险型前置胎盘植入率高,更容易发生严重的产时出血。提前彩超预测、术前充分识别评估风险及产时有效控制出血是治疗的关键。防止DIC发生,减少子宫切除事件及瘢痕子宫的发生,严格掌握剖宫产指征,搞好计划生育,注重产检及营养指导,降低剖宫产率,控制社会因素瘢痕子宫的发生可预防凶险型前置胎盘发生。
Objective: To investigate the clinical features of precarious placenta previa, to prevent the incidence of postpartum hemorrhage, reduce the risk of severe postpartum hemorrhage and hysterectomy, improve perinatal survival and reduce maternal mortality. Methods: A retrospective analysis was made on the pregnancy outcomes among 43 cases of central plains and non-central placenta of dangerous placenta previa. Results: There were significant differences in the incidences of severe postpartum hemorrhage, placenta accreta, DIC and hysterectomy between the central group and the non-central group (P <0.05), while there was no significant difference between the two groups (P> 0.05). Conclusion: The central type of dangerous placenta previa placenta previa than non-central high rate of implantation, more prone to severe bleeding during delivery. Prediction of color Doppler ultrasound, preoperative identification of risk assessment and effective control of bleeding during delivery is the key to treatment. Prevent the occurrence of DIC, reduce the incidence of hysterectomy and scarring of the uterus, strictly control indications of cesarean section, improve family planning, pay attention to the production and nutritional guidance, reduce the rate of cesarean section, control social factors scarring of the uterus can prevent dangerous type Placenta previa occurred.