【摘要】：目的:探討前次剖宮產(chǎn)手術(shù)對(duì)再次妊娠胎盤(pán)植入及其類(lèi)型的影響。方法:回顧性分析2012年1月至2016年12月在成都市婦女兒童中心醫(yī)院分娩的11025例瘢痕子宮(前次剖宮產(chǎn)術(shù))孕婦的臨床資料,其中再次妊娠時(shí)1274例發(fā)生胎盤(pán)植入(粘連型905例,植入型309例,穿透型60例)。分析前次剖宮產(chǎn)是否伴發(fā)產(chǎn)后出血、前次剖宮產(chǎn)是否為產(chǎn)程中轉(zhuǎn)急診手術(shù)以及前次剖宮產(chǎn)距離本次妊娠時(shí)間與再次妊娠胎盤(pán)植入發(fā)生以及類(lèi)型的關(guān)系。結(jié)果:(1)前次剖宮產(chǎn)伴發(fā)產(chǎn)后出血再次妊娠時(shí)胎盤(pán)植入總的發(fā)生率及3種類(lèi)型的發(fā)生率均高于剖宮產(chǎn)后無(wú)產(chǎn)后出血組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)前次剖宮產(chǎn)為產(chǎn)程中轉(zhuǎn)急診手術(shù)再次妊娠時(shí)胎盤(pán)植入總的發(fā)生率及3種類(lèi)型的發(fā)生率均高于前次剖宮產(chǎn)為非產(chǎn)程中轉(zhuǎn)手術(shù),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)前次剖宮產(chǎn)距離本次妊娠的不同時(shí)間與再次妊娠時(shí)胎盤(pán)植入總的發(fā)生率及三種類(lèi)型的發(fā)生率,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:前次剖宮產(chǎn)手術(shù)伴發(fā)產(chǎn)后出血、產(chǎn)程中轉(zhuǎn)急診剖宮產(chǎn)手術(shù)與再次妊娠時(shí)胎盤(pán)植入的發(fā)生可能有關(guān),孕期應(yīng)加強(qiáng)對(duì)這部分孕婦的管理。
[Abstract]:Objective: to investigate the effect of previous cesarean section on placenta accreta and its types. Methods: the clinical data of 11025 pregnant women with scar uterus (previous cesarean section) delivered in Chengdu Women and Children Central Hospital from January 2012 to December 2016 were retrospectively analyzed. 1274 cases of placenta accreta (905 cases of adherent type) were found in the second pregnancy. There were 309 cases of implantation type and 60 cases of penetrating type. To analyze whether the previous cesarean section is accompanied by postpartum hemorrhage, whether the previous cesarean section is a transitional stage of labor, and whether the time between the last cesarean section and the occurrence and type of placenta accreta of the second pregnancy. Results: (1) the total incidence of placenta accreta and the incidence of three types of placenta accreta in the previous cesarean section with postpartum hemorrhage were higher than those in the group without postpartum hemorrhage after cesarean section. The difference was statistically significant (P0.05). (2). The total incidence of placenta accreta and the incidence of three types of placenta accreta in the former cesarean section were higher than those in the previous cesarean section, and the incidence of three types of placenta accreta was higher than that in the previous caesarean section. The difference was statistically significant (P0.05). (3). The total incidence of placenta accreta and the incidence of three types of placenta accreta were not significantly different between the previous cesarean section and the second pregnancy (P0.05). Conclusion: the previous cesarean section with postpartum hemorrhage and the emergency caesarean section during labor may be related to the occurrence of placenta accreta during the second trimester. The management of these pregnant women should be strengthened during pregnancy.
【作者單位】： 成都市婦女兒童中心醫(yī)院;成都市第六人民醫(yī)院;
【分類(lèi)號(hào)】：R714.2

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