标题：瘢痕妊娠前置胎盘产妇的妊娠结局分析

      作者：孟丽，张迪，张海蓉    (山东省立第三医院妇产科，山东 济南 250000)

      卷次： 2018年29卷20期

      【摘要】 目的 研究瘢痕妊娠前置胎盘产妇的妊娠结局情况。方法 回顾性分析山东省立第三医院妇产科2010年5月至2017年5月间诊治的105例前置胎盘产妇的临床资料，依照子宫是否伴有瘢痕分成观察组和对照组，对照组为49例仅出现前置胎盘的产妇，观察组为56例瘢痕妊娠的前置胎盘产妇。比较两组产妇分娩中的出血量、产后1 d出血量、手术时间、妊娠结局及预后情况。结果 观察组产妇的分娩中出血量和产后1 d出血量分别为(1628.12±285.46) mL、(1 223.19±258.32) mL，明显高于对照组的(860.48±185.39) mL、(984.02±212.67) mL，手术时间为(68.26±11.17) min，明显长于对照组的(29.73±4.61) min，差异均有统计学意义(P<0.05)；观察组产妇的不良结局发生率为 33.93%，明显高于对照组的 10.20%，差异有统计学意义(P<0.05)；观察组围产儿的不良结局发生率为64.29%，明显高于对照组的28.57%，差异有统计学意义(P<0.05)；观察组产妇的术后并发症发生率为67.86%，明显高于对照组的24.49%，差异有统计学意义(P<0.05)。结论 瘢痕妊娠前置胎盘产妇分娩存在较大风险，产妇及胎儿均存在高概率的不良妊娠结局，预后也不理想，临床出现此类产妇必须密切关注并给予及时治疗。
      【关键词】 瘢痕妊娠；前置胎盘；妊娠结局；预后
      【中图分类号】 R714.2 【文献标识码】 A 【文章编号】 1003—6350（2018）20—2903—03

Pregnancy outcome of pregnant women with placenta previa in scar pregnancy.
MENG Li, ZHANG Hai-di, ZHANGHai-rong. Department of Obstetrics and Gynecology, Shandong Provincial Third Hospital, Jinan 250000, Shandong, CHINA
【Abstract】 Objective To study the pregnancy outcome of pregnant women with placenta previa in scar preg-nancy. Methods The clinical data of 105 patients with placenta previa admitted from May 2010 to May 2017 in De-partment of Gynecology and Obstetrics of Shandong Provincial Third Hospital were retrospectively analyzed. The pa-tients were divided into observation group and control group according to whether the uterus was accompanied byscar: 49 patients of placenta previa only were enrolled into the control group, and 56 patients of cesarean scar pregnan-cy with placenta previa were included in the observation group. The operation time, blood loss during childbirth,blood loss in one day after delivery, pregnancy outcome and prognosis of the two groups were observed and analyzed.Results The blood loss during childbirth and the blood loss in one day after delivery in the observation group were(1 628.12 ± 285.46) mL, (1 223.19 ± 258.32) mL, respectively, significantly higher than the corresponding (860.48 ±185.39) mL, (984.02±212.67) mL in the control group. The operation time was (68.26±11.17) min, significantly longerthan (29.73±4.61) min in the control group (P<0.05). The incidence of adverse outcomes was 33.93% in the observa-tion group versus 10.20% in the control group (P<0.05). The incidence of adverse perinatal outcomes was 64.29% inthe observation group versus 28.57% in the control group (P<0.05). The incidence of postoperative complications was67.86% in the observation group versus 24.49% in the control group (P<0.05). Conclusion Pregnant women withplacenta previa in scar pregnancy have greater risk of childbirth. There is a high probability of bad pregnancy out-come in both parturients and fetus, and the prognosis is not ideal. These women should be paid close attention to andgiven timely treatment.
      【Key words】 Scar pregnancy; Placenta previa; Pregnancy outcome; Prognosis·短篇论著·doi:10.3969/j.issn.1003-6350.2018.20.028