Chervenak F A, Lee Y, Hendler M A, Monoson R F, Berkowitz R L
Obstet Gynecol. 1984 Dec;64(6):798-801.
Sixty-nine documented cases of placenta previa were managed at The Mount Sinai Medical Center during a five-year period. Vaginal delivery was attempted in six instances of partial placenta previa and was successful in five (83%). For these six cases, intrapartum bleeding was not excessive, blood transfusions were not necessary during or after labor, and all Apgar scores were greater than or equal to 7 at one and five minutes. Anemia in a neonate delivered at 32 weeks of gestation was the only neonatal complication that may have been due to intrapartum fetal hemorrhage. This series suggests that routine cesarean section is not necessary for all cases of partial placenta previa. A protocol is proposed for the intrapartum management of suspected placenta previa at term. Further clinical studies are necessary to evaluate the safety and clinical use of this mode of management.
在五年期间，西奈山医疗中心对69例记录在案的前置胎盘病例进行了处理。对于部分前置胎盘的6例患者尝试进行阴道分娩，其中5例成功（83%）。对于这6例患者，产时出血不多，分娩期间或之后无需输血，所有新生儿1分钟和5分钟阿氏评分均大于或等于7分。孕32周分娩的新生儿贫血是唯一可能因产时胎儿出血导致的新生儿并发症。该系列研究表明，并非所有部分前置胎盘病例都需要常规剖宫产。本文提出了一项针对足月疑似前置胎盘患者产时处理的方案。有必要进行进一步的临床研究以评估这种处理方式的安全性和临床应用价值。
