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  • 简介:  【摘 要】:目的:探索瘢痕性子宫合并前置胎盘在临床上的特点,以及对母婴的结局影响。方法:选择在本院产科 2016年 6月到 2018年 6月间医治的 23位瘢痕性的子宫合并前置胎盘的产妇作为观察组,将首次进行剖宫产的前置胎盘孕妇 23位作为对照组。收集两个组孕妇的资料进行观察和研究。两组产妇均接受剖宫产医治。对两个组孕妇在产后的出血的情况、妊娠的结果以及围生儿情况进行探索与比对。结果:两个组的孕妇在剖宫产之后,无痛阴道出血、第一次阴道出血、孕周在生产之前阴道的出血量进行比较,差异均没有统计学上的意义。观察组手术的时间,生产之后出血的量均高于对照的一组。观察组在手术中进行输血、胎盘的植入、胎盘在附着面的缝扎止血、子动脉的栓塞、背包缝合、子宫切除比率均高于对照的一组。观察组胎儿出现窘迫、早产、新生儿的窒息的比率高于对照组。两个组围生儿的死亡比率比较,差异没有统计学的意义。结论:瘢痕性的子宫合并前置的胎盘在临床上的表现主要为无痛性阴道的出血、瘢痕性子宫合并前置胎盘,手术时间相对比较长,产后出血量多,术中的止血难度增加,而且围生儿的结局较差。    【关键词】:瘢痕子宫 ;前置胎盘 ;临床特点 ;母婴结局  [Abstract]: Objective: To explore the clinical characteristics of cicatricial uterus with placenta previa and its effect on the outcome of mother and infant. Methods: 23 pregnant women with cicatricial uterus and placenta previa treated in our obstetrics department from June 2016 to June 2018 were selected as the observation group, and 23 pregnant women with placenta previa who had first cesarean section were selected as the control group. Data of pregnant women in two groups were collected for observation and study. Both groups received cesarean section. To explore and compare the two groups of pregnant women's postpartum hemorrhage, pregnancy results and perinatal conditions. Results: there was no significant difference between the two groups in the amount of painless vaginal bleeding, first vaginal bleeding and vaginal bleeding before delivery. The time of operation and the amount of bleeding in the observation group were higher than those in the control group. In the observation group, blood transfusion, placenta implantation, placenta ligation on the attachment surface, subarterial embolization, backpack suture and hysterectomy were all higher than those in the control group. The rate of fetal distress, premature delivery and neonatal asphyxia in the observation group was higher than that in the control group. There was no significant difference between the two groups. Conclusion: the clinical manifestations of cicatricial uterus with placenta previa are mainly painless vaginal bleeding, cicatricial uterus with placenta previa. The operation time is relatively long, the amount of postpartum hemorrhage is more, the difficulty of hemostasis is increased, and the perinatal outcome is poor.

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