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目的:探讨广东部分地区前置胎盘合并胎盘植入的危险因素及其对母儿结局的影响。方法:2011年1月至12月在广东四家医院住院分娩的单胎前置胎盘患者共117例,其中合并胎盘植入者17例(病例组),未合并胎盘植入者100例(对照组),比较两组的母儿结局。结果:生育史、产次、流产史、剖宫产史是前置胎盘合并胎盘植入的危险因素(P<0.05)。前置胎盘合并胎盘植入的发生率随着既往剖宫产次数的增加而升高,有0、1、≥2次剖宫产史者的发生率分别为6.5%、42.1%和60.0%。病例组的产后出血、产后输血及子宫切除率均显著高于对照组(P<0.05),但两组的新生儿分娩孕周、出生体重均无显著差异(P>0.05)。结论:(1)减少产次,流产次数,降低剖宫产率,可减少前置胎盘合并胎盘植入的发生率;(2)前置胎盘合并胎盘植入与母体病率有关,但与新生儿结局无关;(3)重视产前诊断,为手术做好充分准备,有助于降低母儿的发病率和死亡率。
Objective: To explore the risk factors of placenta accreta and placenta accreta in some areas of Guangdong Province and their effects on the outcomes of both mother and child. METHODS: A total of 117 singletonic placenta previa patients hospitalized in four hospitals in Guangdong from January to December 2011 were enrolled. Among them, there were 17 cases with placenta accreta (case group) and 100 cases without placenta accreta Group), maternal and child outcomes of the two groups were compared. Results: The history of birth, delivery times, abortion history and cesarean section history were the risk factors for placenta accreta placenta accreta (P <0.05). The incidence of placenta previa plus placenta accreta increased with the increase in the number of previous cesarean section, with 0,1, ≥2 incidence of cesarean section were 6.5%, 42.1% and 60%. Postpartum hemorrhage, postpartum blood transfusions and hysterectomy rates were significantly higher in the case group than in the control group (P <0.05). However, gestational age and birth weight were not significantly different between the two groups (P> 0.05). Conclusions: (1) To reduce the number of births and abortion, reduce the rate of cesarean section, can reduce the incidence of placenta accreta placenta previa combined placenta accreta; (2) Placenta previa placenta accreta and maternal morbidity, but newborn Children’s outcomes have nothing to do; (3) emphasis on prenatal diagnosis, adequate preparation for surgery, help to reduce maternal morbidity and mortality.