Rosen D M, Peek M J
King George V Hospital, Sydney, New South Wales.
Aust N Z J Obstet Gynaecol. 1994 May;34(2):130-4. doi: 10.1111/j.1479-828x.1994.tb02674.x.
Patients with placenta praevia in the third trimester are routinely confined to hospital for fear of major haemorrhage. Whilst this is arguably necessary for those who have had an episode of antepartum haemorrhage (APH), it is uncertain whether these same management principles are valid for those with placenta praevia without antepartum haemorrhage. A retrospective study was undertaken reviewing the case records of 69 consecutive patients diagnosed with placenta praevia in the third trimester of pregnancy. The outcome of 15 who had had no episodes of bleeding were compared with those who had at least 1 antepartum bleeding episode. Patients with placenta praevia without evidence of APH spent a significantly shorter amount of time in hospital and had a significantly lower rate of emergency delivery, with a neonatal outcome as good if not better than the APH group. We conclude that outpatient management in this cohort of patients may be a safe and cost-effective means of care, and warrants randomized prospective study.
妊娠晚期前置胎盘患者因担心大出血而通常被收住入院。虽然对于那些有产前出血（APH）发作的患者来说这可能是必要的，但对于那些没有产前出血的前置胎盘患者，这些相同的管理原则是否有效尚不确定。进行了一项回顾性研究，回顾了69例在妊娠晚期被诊断为前置胎盘的连续患者的病例记录。将15例无出血发作的患者的结局与至少有1次产前出血发作的患者的结局进行比较。没有产前出血证据的前置胎盘患者住院时间明显较短，急诊分娩率明显较低，新生儿结局即使不比产前出血组好也一样。我们得出结论，对这组患者进行门诊管理可能是一种安全且具有成本效益的护理方式，值得进行随机前瞻性研究。
