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目的探讨瘢痕子宫合并前置胎盘再次剖宫产对母婴结局的影响。方法选取该院2012年1月-2014年12月收治的瘢痕子宫合并前置胎盘孕产妇82例作为研究组,同期仅前置胎盘孕产妇80例作为对照组,所有孕产妇进行相同治疗,观察2组孕产妇分娩结局以及新生儿的情况,比较母婴结局。结果研究组产后大出血、中度及重度贫血、继发产褥感染、胎盘粘连植入、子宫切除等的发生率均高于对照组,围生儿体质量为(2389.48±287.61)g低于对照组围生儿的(2921.44±195.21)g,新生儿早产、窘迫、窒息、贫血、死亡等不良反应的发生率显著高于对照组新生儿,差异均有统计学意义(P<0.05)。结论瘢痕子宫可能增加前置胎盘孕妇不良妊娠的发生率,为更好地保护母婴安全,提倡初产妇进行自然分娩,降低剖宫产手术率。
Objective To investigate the effect of scar cesarean section with placenta previa again on maternal and infant outcome. Methods Totally 82 pregnant women with scarring uterus and placenta previa admitted to our hospital from January 2012 to December 2014 were selected as the study group. Only 80 pregnant women with placenta previa at the same period were selected as the control group. All pregnant women were treated with the same treatment and observed 2 maternal childbirth outcomes and the situation of newborns, maternal and child outcomes. Results The incidence of postpartum hemorrhage, moderate and severe anemia, secondary puerperal infection, placenta accreta and hysterectomy were all higher in the study group than those in the control group. The perinatal weight was (2389.48 ± 287.61) g lower than that of the control The incidence of perinatal (2921.44 ± 195.21) g, neonatal premature birth, distress, asphyxia, anemia, death and other adverse reactions was significantly higher than that of the control group, the difference was statistically significant (P <0.05). Conclusion The uterus of scar may increase the incidence of adverse pregnancy in placenta previa. In order to better protect the safety of mother and infant, primipara promote the natural delivery and reduce the rate of cesarean section.