Please wait a minute...
Journal of ZheJiang University(Medical Science)  2015, Vol. 44 Issue (3): 253-257    DOI: 10.3785/j.issn.1008-9292.2015.05.03
    
Maternal outcomes in pregnant women with pernicious placenta previa
ZHU Chang-kun, WANG Fei, ZHOU Yu-mei, YING Jun, CHEN Dan-qing
Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
Download: HTML (   PDF(521KB)
Export: BibTeX | EndNote (RIS)      

Abstract  

Objective: To analyze the maternal outcomes of pregnant women with pernicious placenta previa(PPP). Methods: Clinical data of 470 patients with placenta previa admitted in Women's Hospital Zhejiang University School of Medicine from August 2012 to August 2014 were collected and retrospectively analyzed. The patients were divided into pernicious group(n=101) and non-pernicious group(n=369) according to the history of cesarean section and location of placenta attached to the uterine. The general profiles, maternal outcomes of two groups were compared. Results: The age, gravidity and rate of recurrent cavity surgery of pernicious group [(32.5±4.1) y, 3.4±1.2, 28.7%] were higher than those of non-pernicious group[(30.7±4.5) y, 2.1±1.4,13.6%](P<0.05). The gestational age of pernicious group was (35.6±2.7) weeks, less than that of non-pernicious group [(36.7±2.7) weeks, P<0.001]. Rate of postpartum massive hemorrhage, rate of blood transfusion, rate of placental implantation and hysterectomy in pernicious and non-pernicious group were 29.7%, 35.6%, 27.7%, 11.9% and 8.1%, 10.8%, 5.7%, 0.8%, respectively(P<0.05). Multiple regression analysis showed that placenta accrete was significantly associated with postpartum massive hemorrhage in pernicious group(P<0.05). Conclusion: The awareness of the danger of pregnant women with PPP before operation and paying more attention to antenatal care are key measures to decrease the adverse maternal outcomes of pregnant women with placenta previa.



Key wordsCesarean section/adverse effects      Placenta accreta      Placenta previa      Cicatrix      Uterine diseases      Treatment outcome      Postpartum hemorrhage/etiology      Retrospective studies     
Received: 03 December 2014      Published: 25 May 2015
CLC:  R714  
Cite this article:

ZHU Chang-kun, WANG Fei, ZHOU Yu-mei, YING Jun, CHEN Dan-qing. Maternal outcomes in pregnant women with pernicious placenta previa. Journal of ZheJiang University(Medical Science), 2015, 44(3): 253-257.

URL:

http://www.zjujournals.com/med/10.3785/j.issn.1008-9292.2015.05.03     OR     http://www.zjujournals.com/med/Y2015/V44/I3/253


再生育孕妇合并凶险性前置胎盘的妊娠结局分析

目的:探讨再生育孕妇合并凶险性前置胎盘的妊娠结局。方法:回顾性收集2012年8月至2014年8月在浙江大学医学院附属妇产科医院产科住院且分娩的470例前置胎盘孕妇资料,按有无剖宫产史以及胎盘是否附着在子宫瘢痕处将其分为凶险性前置胎盘组和非凶险性前置胎盘组,比较两组的年龄、孕周、孕次、宫腔手术次数、胎盘植入率、子宫切除率以及并发症等。结果:凶险性前置胎盘孕妇的年龄[(32.5±4.1)岁]、孕次[(3.4±1.2)次]、宫腔多次手术史的比例(28.7%)均大于非凶险性前置胎盘孕妇[(30.7±4.5)岁、(2.1±1.4)次、13.6%,均P<0.05];而凶险性前置胎盘孕妇终止妊娠的孕周[(35.6±2.7)周]小于非凶险性前置胎盘孕妇[(36.7±2.7)周,P<0.001];凶险性前置胎盘孕妇产后大出血发生率、输血率、胎盘植入率、子宫切除率(29.7%、35.6%、27.7%、11.9%)均高于非凶险性前置胎盘孕妇(8.1%、10.8%、5.7%、0.8%,均P<0.05)。多元回归分析结果,胎盘植入与凶险性前置胎盘发生大出血明显相关(P<0.05)。结论:瘢痕子宫再生育妇女要充分评估发生凶险性前置胎盘的风险,加强孕前咨询和孕期监测,减少不良妊娠结局发生。


关键词: 剖宫产术/副作用,  胎盘,侵入性,  前置胎盘,  瘢痕,  子宫疾病,  治疗结果,  产后出血/病因学,  回顾性研究 

[1] 丰有吉,沈 铿,马 丁,等.妇产科学[M].北京:人民卫生出版社,2011: 113-116. FENG You-ji, SHEN Keng, MA Ding, et al. Obstetrics and Gynecology[M]. Beijing: People's Medical Publishing House, 2011: 113-116.(in Chinese)
[2] CRESSWELL J A, RONSMANS C, CALVERT C, et al. Prevalence of placenta praevia by world region: a systematic review and meta-analysis[J]. Trop Med Int Health, 2013, 18(6):712-724.
[3] CHATTOPADHYAY S K, KHARIF H, SHERBEENI M M. Placenta praevia and accreta after previous caesarean section[J]. Eur J Obstet Gynecol Reprod Biol, 1993,52(3):151-156.
[4] SHEINER E, SHOHAM-VARDI I, HALLAK M, et al. Placenta previa: obstetric risk factors and pregnancy outcome[J]. J Matern Fetal Med, 2001,10(6):414-419.
[5] ROSENBERG T, PARIENTE G, SERGIENKO R, et al. Critical analysis of risk factors and outcome of placenta previa[J]. Arch Gynecol Obstet, 2011,284(1):47-51.
[6] HERSHKOWITZ R, FRASER D, MAZOR M, et al. One or multiple previous cesarean sections are associated with similar increased frequency of placenta previa[J]. Eur J Obstet Gynecol Reprod Biol, 1995,62(2):185-188.
[7] MARSHALL N E, FU R, GUISE J M. Impact of multiple cesarean deliveries on maternal morbidity: a systematic review[J]. Am J Obstet Gynecol, 2011,205(3):261-262.
[8] USTA I M, HOBEIKA E M, MUSA A A, et al. Placenta previa-accreta: risk factors and complications[J]. Am J Obstet Gynecol, 2005,193(3 Pt 2):1045-1049.
[9] MILLER D A, CHOLLET J A, GOODWIN T M. Clinical risk factors for placenta previa-placenta accreta[J]. Am J Obstet Gynecol, 1997,177(1):210-214.
[10] JANG D G, WE J S, SHIN J U, et al. Maternal outcomes according to placental position in placental previa[J]. Int J Med Sci, 2011,8(5):439-444.
[11] KAMARA M, HENDERSON J J, DOHERTY D A, et al. The risk of placenta accreta following primary elective caesarean delivery: a case-control study[J]. BJOG, 2013,120(7):879-886.

[1] YE Jianyu,SUN Ziyu,HU Weiwei. Roles of astrocytes in cerebral infarction and related therapeutic strategies[J]. Journal of ZheJiang University(Medical Science), 2018, 47(5): 493-498.
[2] LOU Yelin,ZHOU Yimin,LU Hong,LYU Weiguo. Establishment of a prognostic model for preterm delivery in women after cervical conization[J]. Journal of ZheJiang University(Medical Science), 2018, 47(4): 351-356.
[3] DENG Xuan,HE Hanqing,ZHOU Yang,PAN Jinren,YAN Rui,TANG Xuewen,FU Jian. Economic evaluation of different chickenpox vaccination strategies[J]. Journal of ZheJiang University(Medical Science), 2018, 47(4): 374-380.
[4] ZHANG Yuxi,MO Xuming,SUN Jian,PENG Wei,QI Jirong,WU Kaihong,SU Yaqin. Application of thoracoscopic surgery in repairing esophageal atresia type Ⅲ with tracheoesophageal fistula in neonates[J]. Journal of ZheJiang University(Medical Science), 2018, 47(3): 266-271.
[5] LYU Chengjie,HU Donglai,HUANG Shoujiang,QIN Qi,ZHAO Xiaoxia,HU Shuqi,ZHANG Yanan,FANG Xuan,GUO Xiaodong,TOU Jinfa. Transumbilical single-site laparoscopic surgery for congenital duodenal obstruction in neonates[J]. Journal of ZheJiang University(Medical Science), 2018, 47(3): 261-265.
[6] ZHANG Shisong,WU Yurui,LIU Hongzhen,ZHAI Yunpeng,LIU Wei. Experience in treatment of complex congenital intestinal atresia in children[J]. Journal of ZheJiang University(Medical Science), 2018, 47(3): 255-260.
[7] XU Weize,YE Jingjing,LI Jianhua,ZHANG Zewei,YU Jiangen,SHI Zhuo,YU Jin,SHU Qiang. Efficacy of percutaneous atrial septal defect closure guided by transesophageal echocardiography in children[J]. Journal of ZheJiang University(Medical Science), 2018, 47(3): 244-249.
[8] ZHANG Yi,ZHANG Li,ZHANG Qiyu,HONG Weilong,LIN Xiaohua. microRNA-222 regulates proliferation and apoptosis of fibroblasts in hypertrophic scar via matrix metalloproteinase 1[J]. Journal of ZheJiang University(Medical Science), 2017, 46(6): 609-617.
[9] LU Wei,LIN Mengna,ZHAO Shifang,WANG Huiming,HE Fuming. Application of modified lateral window for maxillary sinus floor augmentation[J]. Journal of ZheJiang University(Medical Science), 2017, 46(6): 630-636.
[10] ZHU Ziyi,LI Zhijun,HE Zhengfu,WANG Yunzhen. Endoscopic trans-fistula drainage for gastroesophageal anastomotic fistula with para-fistula abscess after esophagectomy[J]. Journal of ZheJiang University(Medical Science), 2017, 46(6): 637-642.
[11] ZHANG Siying, CHEN Feng. Research progress of CT/MRI parametric response map in precision evaluation of therapeutic response of cancer patients[J]. Journal of ZheJiang University(Medical Science), 2017, 46(5): 468-472.
[12] PAN Jingying, HE Mengye, KE Wei, HU Menglin, WANG Meifang, SHEN Peng. Advances on correlation of PET-CT findings with breast cancer molecular subtypes, treatment response and prognosis[J]. Journal of ZheJiang University(Medical Science), 2017, 46(5): 473-480.
[13] PEI Lei, XU Jingjing, ZHANG Minming. Correlation between high signal intensity in cerebrum nucleus on unenhanced T1-weighted MR images and number of previous gadolinium-based contrast agent administration[J]. Journal of ZheJiang University(Medical Science), 2017, 46(5): 487-491.
[14] LI Aijing, PAN Yuning, CHEN Bin, XIA Jianbi, GAN Fang, JIN Yinhua, ZHENG Jianjun. Association of parameters in dynamic contrast-enhanced MRI using reference region model with prognostic factors and molecular subtypes of breast cancer[J]. Journal of ZheJiang University(Medical Science), 2017, 46(5): 505-510.
[15] ZHANG Ge'er, PAN Zimin. Gestational trophoblastic diseases in cesarean scar: an analysis of 20 cases[J]. Journal of ZheJiang University(Medical Science), 2017, 46(5): 529-536.