胎盘位置与妊娠中期前置胎盘消退的关系。

Yun Feng, Xue-Yin Li, Juan Xiao, Wei Li, Jing Liu, Xue Zeng, Xi Chen, Kai-Yue Chen, Lei Fan, Su-Hua Chen
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引用次数: 2

摘要

本前瞻性研究旨在评估有前胎盘和后胎盘的妇女以及有和没有剖宫产史的妇女妊娠中期前置胎盘的溶解率。在本研究中,前置胎盘被定义为位于颈内os 20mm内或与其重叠的胎盘。我们招募了183名在20+0周到25+6周之间被诊断为前置胎盘的妇女。根据胎盘位置(前位或后位)和剖宫产史进行分组。比较剖宫产组和非剖宫产组的人口学资料、前宫腔清除率和妊娠结局。前胎盘的女性往往会提前产胎(P=0.040),并且会增加扩张和刮宫的次数(P=0.044)。剖宫产组妇女的年龄(P=0.000)、胎次(P=0.000)、妊娠(P=0.000)、扩张刮宫(P=0.048)均明显高于非剖宫产组。在本研究中,有87.43%的妇女在分娩时出现前置症状。有后胎盘的妇女有更高的解决率(P=0.030),而有剖宫产史的妇女没有差异。剖宫产后置组(P=0.002)和非剖宫产组(P=0.008)的胎龄明显早于剖宫产前置组和剖宫产后置组。胎盘位置和既往剖宫产对产科结局和新生儿结局没有影响。本研究表明,对于在妊娠中期被诊断为前置胎盘的妇女,如果胎盘位于后位,则更有可能出现前置胎盘的后续解决。
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Relationship between placenta location and resolution of second trimester placenta previa.

This prospective study was conducted to assess the rate of resolution of second trimester placenta previa in women with anterior placenta and posterior placenta, and that in women with and without previous cesarean section. In this study, placenta previa was defined as a placenta lying within 20 mm of the internal cervical os or overlapping it. We recruited 183 women diagnosed with previa between 20+0 weeks and 25+6 weeks. They were grouped according to their placenta location (anterior or posterior) and history of cesarean section. Comparative analysis was performed on demographic data, resolution rate of previa and pregnancy outcomes between anterior group and posterior group, and on those between cesarean section group and non-cesarean section group. Women with an anterior placenta tended to be advanced in parity (P=0.040) and have increased number of dilatation and curettage (P=0.044). The women in cesarean section group were significantly older (P=0.000) and had more parity (P=0.000), gravidity (P=0.000), and dilatation and curettage (P=0.048) than in non-cesarean section group. Resolution of previa at delivery occurred in 87.43% women in this study. Women with a posterior placenta had a higher rate of resolution (P=0.030), while history of cesarean section made no difference. Gestational age at resolution was earlier in posterior group (P=0.002) and non-cesarean section group (P=0.008) than in anterior group and cesarean section group correspondingly. Placenta location and prior cesarean section did not influence obstetric outcomes and neonatal outcomes. This study indicates that it is more likely to have subsequent resolution of the previa when the placenta is posteriorly located for women who are diagnosed with placenta previa in the second trimester.

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