THE CONSERVATIVE AGGRESSIVE MANAGEMENT OF PLACENTA PREVIA
THE CONSERVATIVE AGGRESSIVE MANAGEMENT OF PLACENTA PREVIA
复制标题
DOI：
10.1016/s0002-9378(15)33242-7
复制
发表时间：
1980-01-01
影响因子：
9.8
通讯作者：
QUILLIGAN, EJ
中科院分区：
文献类型：
--
作者：
COTTON, DB;READ, JA;QUILLIGAN, EJ
对 1975 年 7 月至 1978 年 6 月在洛杉矶县妇女医院 - 南加州大学[美国]医学中心治疗的前置胎盘病例 (173) 进行了回顾，并与 1969 年在同一机构研究的一系列类似病例进行了比较。围产期死亡率为 12.6%，大约是早期研究中的 1/2。胎儿死亡率没有显着变化，但新生儿死亡率明显降低，特别是在 27-32 周范围内。 65.8%的患者采用了期待治疗，而1969年为42.6%。期待治疗比例较高的特点是在出现中度至重度出血时积极使用抗产输血来代替分娩，以及在出现阴道出血时偶尔使用宫缩抑制剂来抑制早产。利用卵磷脂/鞘磷脂比率来确定肺成熟度的选择性终止妊娠也导致新生儿总体发病率和死亡率显着降低。这些多重因素似乎导致前置胎盘相关围产期死亡率的大幅降低。
Cases of placenta previa (173) managed at the Women''s Hospital of Los Angeles County-University of Southern California [USA] Medical Center from July, 1975, through June, 1978, were reviewed and compared to a similar series of cases studied in the same institution in 1969. The perinatal mortality of 12.6% was roughly 1/2 of that in the earlier study. The fetal death rate did not change significantly, but the neonatal mortality was markedly less, especially in the 27-32 wk range. Expectant management was employed in 65.8% of patients, as compared to 42.6% in 1969. The higher rate of expectant management was characterized by the aggressive use of antipartum transfusions in the face of moderate-to-severe bleeding in lieu of delivery, as well as the occasional use of tocolytic agents for inhibition of premature labor in the presence of vaginal bleeding. Elective termination of pregnancy utilizing the lecithin/sphingomyelin ratio for determination of pulmonary maturation also resulted in significantly less overall neonatal morbidity and mortality. These multiple factors appear to have contributed to a dramatic reduction in the perinatal mortality associated with placenta previa.