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目的:探讨前置胎盘状态下终止妊娠对母亲的影响和对策。方法:分析我院2年来胎盘前置状态的发病情况,产前检查情况以及母亲终止妊娠结局。结果:在终止20～28周妊娠的患者(720)例中,前置胎盘状态患者30例,在引产中,临产后完全性前置胎盘状态可因宫口扩张而变为部分性,边缘性以及低置性胎盘等,妊娠终止可采用米非司酮配伍利凡诺羊膜腔内注射等方法,绝大部分胎盘前置状态可以顺利经阴道分娩,但少部分凶险型前置胎盘以及合并胎盘植入者可发生致命性出血,需要采用宫腔填塞,气囊加压,动脉栓塞介入治疗以及子宫切除等等。结论:采用米非司酮配伍利凡诺羊膜腔内注射方法,终止20～28周妊娠的前置胎盘状态患者,绝大多数可以经阴道顺利娩出,但终止妊娠时也可产生前置胎盘产后一样的难以控制的出血,需高度警惕,密切关注,及时采取有效措施,挽救生命。
Objective: To investigate the effect of termination of pregnancy on mothers under placenta previa and its countermeasures. Methods: To analyze the incidence of placenta previa in our hospital in 2 years, the status of prenatal examination and termination of pregnancy. RESULTS: Among the 720 patients who terminated pregnancies between 20 and 28 weeks, 30 patients had placenta previa. During labor, the condition of prenatal complete placenta previa may be partially and marginalized due to dilatation of the cervix And placenta accreta, termination of pregnancy can be used mifepristone Rivaroxone amniotic cavity injection and other methods, most of the placenta previa vaginal delivery state can be smooth, but a small part of the risk of placenta previa and placenta accreta Implants can occur fatal bleeding need to use uterine packing, balloon compression, arterial embolization and hysterectomy and so on. CONCLUSION: The majority of patients with placenta accreta terminated with 20-28 weeks’ gestation by intramuscular injection of mifepristone and rivanol can deliver the vagina smoothly, but the prenatal placenta can also be produced after termination of pregnancy The same difficult to control the bleeding, need a high degree of vigilance, pay close attention to timely and effective measures to save lives.