前置胎盘课件.pdfVIP

前置胎盘 前置胎盘 定义 定义 孕28周后，胎盘附于子宫下段，甚至胎盘下缘达 孕28周后，胎盘附于子宫下段，甚至胎盘下缘达 到或覆盖宫颈内口，位置低于胎儿先露部，称 到或覆盖宫颈内口，位置低于胎儿先露部，称 为前置胎盘 为前置胎盘 分类 分类 中央型前置胎盘: the internal cervical os is 中央型前置胎盘: the internal cervical os is covered completely by placenta. covered completely by placenta. 部分性前置胎盘: the internal os is partially 部分性前置胎盘: the internal os is partially covered by placenta. covered by placenta. 边缘性前置胎盘: the edge of the placenta is 边缘性前置胎盘: the edge of the placenta is at the margin of the internal os. at the margin of the internal os. 低置胎盘: the placenta is implanted in the 低置胎盘: the placenta is implanted in the lower uterine segment such that the lower uterine segment such that the placenta edge actually does not reach the placenta edge actually does not reach the internal os but is in close proximity to it. internal os but is in close proximity to it. 分类 分类 前置胎盘类型判定 前置胎盘类型判定 根据检查当时，宫口扩张和胎盘位置关 根据检查当时，宫口扩张和胎盘位置关 系确定如低置胎盘在宫口开2厘米时，能 系确定如低置胎盘在宫口开2厘米时，能 变成部分性前置胎盘。 变成部分性前置胎盘。 肛查确定宫口扩张和胎盘关系是非常危 肛查确定宫口扩张和胎盘关系是非常危 险，引发严重大出血（severe 险，引发严重大出血（severe hemorrhage ）. hemorrhage ）. 胎盘移行 胎盘移行 Gestational age at Previa or hemorrhage Gestational age at Previa or hemorrhage sonography(wk) at delivery (%) sonography(wk) at delivery (%) 20 2.3 20 2.3 20 25 3.2 - 3.2 20-25 25 30