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目的分析凶险型前置胎盘的诊断、围手术期的处理及感染预防,改善妊娠结局。方法回顾性对比分析作者产科分娩的42例凶险型前置胎盘患者和90例普通型组前置胎盘患者的病历资料。结果 42例凶险型前置胎盘孕妇发生胎盘植入率35.71%,产前出血率19.4%,产后出血率47.62%,子宫切除率23.81%,围生儿重度窒息率21.42%,均明显高于普通型前置胎盘的孕妇(P<0.05);平均分娩孕周31.66±4.01周,早于普通型组;新生儿死亡率两组无明显差异(P>0.05)。结论凶险型前置胎盘对孕产妇的危害很大,容易引起围生儿缺氧窒息甚至死胎、死产,对围手术期的处理能力要求高。减少首次分娩剖宫产率、加强产前检查、发现凶险型前置胎盘后及时到相关高级别的综合性医院待产可以有效改善母婴的预后。
Objective To analyze the diagnosis of perilous placenta previa, perioperative management and infection prevention, and to improve the outcome of pregnancy. Methods Retrospective analysis of the author’s obstetric delivery of 42 cases of dangerous placenta previa and 90 cases of common type placenta previa patients with medical records. Results The placenta accreta rate was 35.71%, the rate of prenatal hemorrhage was 19.4%, the rate of postpartum hemorrhage was 47.62%, the hysterectomy rate was 23.81% and the perinatal asphyxia rate was significantly higher in 42 cases of dangerous placenta previa (P <0.05). The mean gestational age was 31.66 ± 4.01 weeks, which was earlier than that of the normal group. There was no significant difference in neonatal mortality between the two groups (P> 0.05). Conclusion Dangerous placenta previa placenta is very harmful to pregnant women, easily lead to perinatal hypoxia and asphyxia or stillbirth, stillbirth, high perioperative handling capacity. Reduce the rate of cesarean section for the first time delivery, strengthen prenatal care and found that the risk of placenta previa in a timely manner to the relevant high-level general hospital to be produced can effectively improve the prognosis of mother and child.