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目的分析瘢痕子宫合并中央性前置胎盘妊娠及分娩过程中的处理方式。方法回顾性分析2005年1月1日-2014年12月31日瘢痕子宫合并中央性前置胎盘患者48例临床病理资料。结果瘢痕子宫合并中央性前置胎盘者42例,占全部瘢痕子宫住院孕妇约1.5%,占同期中央性前置胎盘住院孕妇的20.1%,是以无痛性出血为主要表现;前壁胎盘24例,后壁胎盘18例,侧壁胎盘6例;超声仅16例考虑胎盘植入,行子宫切除患者30例,胎盘位于前壁者60%患者切除子宫,42例出血>1 500 ml者中30例患者切除子宫。全部孕妇无一例死亡。结论瘢痕子宫合并中央性前置胎盘者病情凶险,尤其以前壁胎盘者为最,出血>1 500 ml时,若仍出血汹涌,应考虑切除子宫,挽救产妇生命。
Objective To analyze the treatment of uterus scarring with central placenta previa during pregnancy and childbirth. Methods A retrospective analysis of January 1, 2005 - December 31, 2014 scarring uterus with central placenta previa patients with 48 cases of clinicopathological data. Results 42 cases of scarring uterus with central placenta previa, accounting for about 1.5% of all pregnant women with scar uterus, accounting for 20.1% of pregnant women with central placenta previa in the same period, with painless bleeding as the main performance; anterior wall placenta 24 18 cases of posterior wall placenta and 6 cases of sidewall placenta; only 16 cases of ultrasound considered placenta accreta, 30 cases of hysterectomy, 60% of patients with placenta in the anterior wall and 42 cases of bleeding> 1 500 ml Thirty patients underwent removal of the uterus. None of all pregnant women died. Conclusion The scarring uterus with central placenta previa is dangerous, especially when the anterior wall placenta is the most, bleeding> 1 500 ml, if the bleeding is still surging, we should consider the removal of the uterus and save the lives of mothers.