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目的探讨瘢痕子宫合并前置胎盘的临床特点及其对母婴结局的影响。方法选择扬州苏北人民医院产科2012年3月-2016年6月收治的100例瘢痕子宫合并前置胎盘孕妇作为观察组,初次剖宫产的前置胎盘孕妇100例作为对照组,收集两组孕产妇的临床资料。结果两组无痛性阴道出血例数、初次阴道出血孕周、产前阴道出血量比较,差异均无统计学意义(P>0.05)。观察组手术时间、产后出血量均高于对照组(P<0.05),观察组术中输血、胎盘植入、胎盘附着面缝扎止血、子动脉栓塞、背包缝合、子宫切除率均高于对照组(P<0.05)。观察组胎儿窘迫、早产、新生儿窒息的发生率高于对照组(P<0.05),两组围生儿死亡率比较,差异无统计学意义(P>0.05)。结论瘢痕子宫合并前置胎盘的临床表现主要为无痛性阴道出血,瘢痕子宫合并前置胎盘手术时间较长,产后出血量较多,术中止血难度增加,围生儿结局较差。
Objective To investigate the clinical features of scarring uterus with placenta previa and its effect on maternal and infant outcomes. Methods 100 cases of uterus with placenta previa combined with placenta previa from March 2012 to June 2016 in Yangzhou Subei People’s Hospital were enrolled as observation group and 100 cases of placenta previa placenta pregnant women as control group.The two groups were collected Clinical data of pregnant women. Results There were no significant differences between the two groups in the number of painless vaginal bleeding, the first gestational vaginal bleeding and the amount of prenatal vaginal bleeding (P> 0.05). The operation time and the amount of postpartum hemorrhage in the observation group were higher than those in the control group (P <0.05). The intraoperative blood transfusion, placenta accreta, placenta accreta suture hemostasis, arterial embolism, backpack suture and hysterectomy were all higher in the observation group than those in the control group Group (P <0.05). The incidence of fetal distress, premature birth and neonatal asphyxia in the observation group was higher than that in the control group (P <0.05). There was no significant difference in perinatal mortality between the two groups (P> 0.05). Conclusions The main manifestations of scarring uterus with placenta previa are painless vaginal bleeding, scarring uterus with placenta previa surgery longer, more postpartum hemorrhage, intraoperative hemostasis more difficult, poor perinatal outcome.