论文部分内容阅读
目的:探讨前置胎盘孕妇产前超声评估对预测产时大出血的临床价值。方法:选取2012年1月至2015年1月在我院诊断为持续性前置胎盘(妊娠晚期和/或分娩期胎盘仍为持续状态)的孕妇60名,结合孕妇临床表现和产前超声检查,分析在剖宫产术中出现大出血的预测因素。结果:60名产妇中,有22例(36.7%)出现术中大出血(>1500 m L)。对22例出现大出血的产妇进行分组比较发现,既往有子宫手术史,前置胎盘距离宫颈内口更近甚至覆盖内口,缺乏透明带和胎盘植入的产妇,都表现出产时出血量增加,相比较未发生大出血的产妇,差异有统计学意义(P<0.05)。胎盘覆盖宫颈内口,缺乏透明带,胎盘缺损,彩色多普勒异常的产妇在剖宫产时发生大出血的概率更高(P<0.05)。结论:胎盘覆盖宫颈内口,缺乏透明带,胎盘植入,彩色多普勒异常的产妇在剖宫产时发生大出血的概率更高,可作为预测产时大出血的因素。
Objective: To investigate the clinical value of prenatal ultrasound in pregnant women with placenta previa to predict major hemorrhage during delivery. Methods: Sixty pregnant women diagnosed with persistent placenta in our hospital from January 2012 to January 2015 (placenta in late pregnancy and / or during childbirth) were selected. Combined with the clinical manifestations and prenatal ultrasound examination , Analysis of predictors of major bleeding in cesarean section. Results: Out of the 60 mothers, intraoperative bleeding (> 1500 m L) occurred in 22 patients (36.7%). 22 cases of bleeding occurred in the maternal group found that previous history of uterine surgery, placenta previa from the cervix closer to the mouth or even cover the mouth, lack of zona pellucida and placenta accreta, have shown an increase in intrapartum bleeding, The difference was statistically significant (P <0.05) compared with those without bleeding. Placenta covering the cervix in the mouth, the lack of zona pellucida, placental defects, color Doppler abnormalities in women with caesarean section when the occurrence of major bleeding more likely (P <0.05). CONCLUSION: The probability of severe bleeding during cesarean section is higher in placenta covered by cervix, lack of zona pellucida, placenta accreta and color Doppler abnormalities, which may be used as a predictor of major bleeding during delivery.