Clinical Analysis of 52 Gravidas with Placenta Praevia

doi:10.3877/cma.j.issn.1673-5250.2014.03.019

Objective

To investigate the relationship between different degrees of placenta praevia and clinical outcomes.

Methods

From July 2009 to July 2013, a total of 52 patients with placenta praevia were included in the study. They were divided into total placenta praevia group(n=20), partial placenta praevia group(n=15) and marginal placenta praevia group(n=17). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Fifth People's Hospital of Chengdu.Informed consent was obtained from each patients.

Results

The incidence rate of placenta praevia was 2.03%(52/2 565). Statistical differences were found among three groups in the gestational weeks at first bleeding, diagnosis and delivery(t=8.53, 7.78, 6.79, 6.51, 5.36, 4.79; P<0.05). The blood loss and cesarean section rate were obviously higher in total placenta praevia group than those of partial placenta praevia group and marginal placenta praevia group(t=12.93, 15.35, 7.56, 6.78; P<0.05). There also had significant differences in birth weight among three groups(t=10.35, 11.01; P<0.05).

Conclusions

Compared with partial and marginal placenta praevia, clinical outcomes of patients with total placenta praevia are much worse. The diagnosis of placenta praevia as early as possible could help us to evaluate the patients' condition and provide guidance of clinical management, and finally obtain good clinical outcomes.

Key words: Placenta praevia, Cesarean section, Placenta accrete

表1 3组患者一般临床资料比较[n(%)]

Table 1 Comparison of general clinical data among three groups[n(%)]

组别	n	年龄(岁)			剖宫产史(次)
组别	n	<30	30～35	>35	0	1	2
中央性前置胎盘组	20	13(25.00)	4(7.69)	3(5.77)	18(34.62)	2(3.85)	0(0.00)
部分性前置胎盘组	15	10(19.23)	3(5.77)	2(3.85)	13(25.00)	1(1.92)	1(1.92)
边缘性前置胎盘组	17	12(23.08)	3(5.77)	2(3.85)	15(28.85)	2(3.85)	0(0.00)
组别	流产史(次)				产次(次)		妊娠期合并症
组别	0	1	2	3	1	2	妊娠期高血压疾病	妊娠期糖尿病
中央性前置胎盘组	5(9.62)	9(17.31)	4(7.69)	2(3.85)	15(28.85)	5(9.62)	2(3.85)	1(1.92)
部分性前置胎盘组	4(7.69)	7(13.46)	2(3.85)	2(3.85)	12(23.08)	3(5.77)	0(0.00)	0(0.00)
边缘性前置胎盘组	5(9.62)	8(15.38)	3(5.77)	1(1.92)	15(28.85)	2(3.85)	2(3.85)	0(0.00)

表1 3组患者一般临床资料比较[n(%)]

Table 1 Comparison of general clinical data among three groups[n(%)]

组别	n	年龄(岁)			剖宫产史(次)
组别	n	<30	30～35	>35	0	1	2
中央性前置胎盘组	20	13(25.00)	4(7.69)	3(5.77)	18(34.62)	2(3.85)	0(0.00)
部分性前置胎盘组	15	10(19.23)	3(5.77)	2(3.85)	13(25.00)	1(1.92)	1(1.92)
边缘性前置胎盘组	17	12(23.08)	3(5.77)	2(3.85)	15(28.85)	2(3.85)	0(0.00)
组别	流产史(次)				产次(次)		妊娠期合并症
组别	0	1	2	3	1	2	妊娠期高血压疾病	妊娠期糖尿病
中央性前置胎盘组	5(9.62)	9(17.31)	4(7.69)	2(3.85)	15(28.85)	5(9.62)	2(3.85)	1(1.92)
部分性前置胎盘组	4(7.69)	7(13.46)	2(3.85)	2(3.85)	12(23.08)	3(5.77)	0(0.00)	0(0.00)
边缘性前置胎盘组	5(9.62)	8(15.38)	3(5.77)	1(1.92)	15(28.85)	2(3.85)	2(3.85)	0(0.00)

表2 3组患者本次妊娠情况比较(孕周，±s)

Table 2 Comparison of current pregnancy condition among three groups(gestational week,±s)

组别	n	首次出血孕龄	诊断孕龄	分娩孕龄
中央性前置胎盘组	20	29.3±2.2	33.2±3.2	35.4±2.3
部分性前置胎盘组	15	32.5±3.6^a	36.6±2.9^c	37.3±1.8^e
边缘性前置胎盘组	17	35.5±2.6^b	36.4±2.5^d	37.3±2.5^f

表2 3组患者本次妊娠情况比较(孕周，±s)

Table 2 Comparison of current pregnancy condition among three groups(gestational week,±s)

组别	n	首次出血孕龄	诊断孕龄	分娩孕龄
中央性前置胎盘组	20	29.3±2.2	33.2±3.2	35.4±2.3
部分性前置胎盘组	15	32.5±3.6^a	36.6±2.9^c	37.3±1.8^e
边缘性前置胎盘组	17	35.5±2.6^b	36.4±2.5^d	37.3±2.5^f

表3 3组患者妊娠结局比较(mL,±s)

Table 3 Comparison of pregnancy outcomes among three groups(mL,±s)

组别	n	产后出血量	剖宫产率[n(%)]
中央性前置胎盘组	20	816.2±25.5	20(100.0)
部分性前置胎盘组	15	627.6±19.4^a	13(86.67)^c
边缘性前置胎盘组	17	465.2±23.6^b	15(88.24)^d

表3 3组患者妊娠结局比较(mL,±s)

Table 3 Comparison of pregnancy outcomes among three groups(mL,±s)

组别	n	产后出血量	剖宫产率[n(%)]
中央性前置胎盘组	20	816.2±25.5	20(100.0)
部分性前置胎盘组	15	627.6±19.4^a	13(86.67)^c
边缘性前置胎盘组	17	465.2±23.6^b	15(88.24)^d

表4 3组新生儿结局比较(g,±s)

Table 4 Comparison of neonatal outcomes among three groups(g,±s)

组别	n	出生体质量	1 min Apgar≤7分新生儿率[n(%)]
中央性前置胎盘组	20	2 100±525.5	4(20.0)
部分性前置胎盘组	15	2 650±579.3^a	2(13.3)
边缘性前置胎盘组	17	2 750±612.6^b	2(11.8)

表4 3组新生儿结局比较(g,±s)

Table 4 Comparison of neonatal outcomes among three groups(g,±s)

组别	n	出生体质量	1 min Apgar≤7分新生儿率[n(%)]
中央性前置胎盘组	20	2 100±525.5	4(20.0)
部分性前置胎盘组	15	2 650±579.3^a	2(13.3)
边缘性前置胎盘组	17	2 750±612.6^b	2(11.8)

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