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目的探究与分析前置胎盘妊娠期出血对妊娠结局的影响。方法选取该院2010年8月-2015年8月收治的60例前置胎盘妊娠期出血患者作为观察组,根据前置胎盘的类型分为中央组、边缘组及部分组,另选择同期收治的前置胎盘未出血患者60例作为对照组,同样根据前置胎盘的类型分为中央组、边缘组及部分组,比较观察组与对照组中相应前置胎盘类型患者的孕产次、流产及宫腔操作次数、入院时孕周及前置胎盘类型,对比中央组、边缘组、部分组与对照组产后出血量、剖宫产、自然产、终止妊娠孕周、住院天数、新生儿体重、新生儿窒息、新生儿死亡及Apgar评分。结果观察组与对照组相比,孕产次、流产及宫腔操作次数较高,入院时孕周较短,其中,中央性前置胎盘比例较高,差异均有统计学意义(t=3.44,P<0.05;t=3.56,P<0.05;t=3.99,P<0.05;χ~2=5.45,P<0.05)。观察中央组与对照中央组相比,产后出血量较多,剖宫产率较高,终止妊娠孕周较短,住院天数较长,差异均有统计学意义(t=6.56,P<0.01;χ~2=6.38,P<0.01;t=5.42,P<0.01;t=5.21,P<0.01)。观察部分组与对照部分组相比,产后出血量较多,剖宫产率较高,终止妊娠孕周较短,住院天数较长,差异均有统计学意义(t=6.23,P<0.05;χ~2=6.11,P<0.05;t=5.21,P<0.05;t=5.09,P<0.05)。观察边缘组与对照边缘组相比,产后出血量较多,剖宫产率较高,自然产率较低,住院天数较长,差异均有统计学意义(t=5.76,P<0.05;χ~2=5.69,P<0.05;χ~2=5.73,P<0.05;t=4.98,P<0.05)。观察中央组与对照中央组相比,新生儿体重较低,新生儿窒息率较高,Apgar评分较低,差异均有统计学意义(t=3.23,P<0.05;t=3.56,P<0.05;t=3.23,P<0.05)。观察部分组与对照部分组相比,新生儿体重较低,Apgar评分较低,差异有统计学意义(t=3.11,P<0.05;t=3.23,P<0.05)。观察边缘组与对照边缘组相比,新生儿体重较低,Apgar评分较低,差异有统计学意义(t=3.01,P<0.05;t=2.87,P<0.05)。结论妊娠期出血对前置胎盘患者的妊娠结局可造成不良影响,其中中央性前置胎盘影响最重,应引起临床工作者的重视。
Objective To investigate and analyze the influence of placenta accreta placenta previa on pregnancy outcome. Methods From January 2010 to August 2015, 60 cases of placenta previa patients with gestational bleeding admitted to our hospital were selected as the observation group. According to the type of placenta previa, the patients were divided into central group, peripheral group and partial group. Sixty patients without placenta previa were selected as the control group. According to the type of placenta previa, they were divided into central group, marginal group and partial group. The incidences of pregnancy, abortion and abortion were compared between the corresponding placenta previa and the control group The number of uterine cavity operation, gestational age and placenta previa on admission were compared with those of central group, marginal group, partial group and control group, postpartum hemorrhage, cesarean section, spontaneous labor, gestational weeks of termination of pregnancy, days of hospitalization, weight of newborn, Neonatal asphyxia, neonatal death and Apgar score. Results Compared with the control group, the number of maternity, abortion and intrauterine operation in observation group was higher than that in control group, and the gestational age at admission was short. Among them, the proportion of central placenta previa was higher, the difference was statistically significant (t = 3.44 , P <0.05; t = 3.56, P <0.05; t = 3.99, P <0.05; Compared with the control group, the central group showed more postpartum hemorrhage, higher cesarean section rate, shorter gestational weeks of pregnancy, longer hospital stay, the differences were statistically significant (t = 6.56, P <0.01; χ ~ 2 = 6.38, P <0.01; t = 5.42, P <0.01; t = 5.21, P <0.01). Compared with the control group, there were more postpartum hemorrhage, higher cesarean section rate, shorter gestational weeks and longer days of hospitalization in the observation group than in the control group (t = 6.23, P <0.05; χ ~ 2 = 6.11, P <0.05; t = 5.21, P <0.05; t = 5.09, P <0.05). Compared with the control group, the marginal group showed more postpartum hemorrhage, higher cesarean section rate, lower natural rate, longer hospital stay, and the differences were statistically significant (t = 5.76, P <0.05; χ ~ 2 = 5.69, P <0.05; χ ~ 2 = 5.73, P <0.05; t = 4.98, P <0.05). Compared with the control group, the central group had lower body weight, higher neonatal asphyxia, and lower Apgar score (t = 3.23, P <0.05; t = 3.56, P <0.05) ; t = 3.23, P <0.05). Compared with the control group, the newborns in the observation group had lower body weight and lower Apgar score, the difference was statistically significant (t = 3.11, P <0.05; t = 3.23, P <0.05). Compared with the control group, the marginal group showed lower body weight and lower Apgar score, the difference was statistically significant (t = 3.01, P <0.05; t = 2.87, P <0.05). Conclusion Pregnancy bleeding can cause adverse effects on the pregnancy outcomes of patients with placenta previa. Among them, the central placenta previa has the greatest impact and should be paid more attention by clinicians.