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目的 分析剖宫产术后再次妊娠发生胎盘植入的不同类型与前次剖宫产间的关联性.方法 对2010年1月至2018年10月北部战区总医院收治的7 286例剖宫产术后再次妊娠孕妇资料做回顾分析,其中发生胎盘植入共842例,植入类型597例为粘连型、204例为植入型、41例为穿透型.对本次妊娠发生胎盘植入的类型与前次剖宫产时是否中转手术、是否产后出血、距本次妊娠的时间等关联性因素进行分析.结果 前次剖宫产发生产程中转手术者再次妊娠胎盘植入的总发生率以及不同胎盘植入类型发生率均较前次剖宫产未产程中转手术者明显升高[总发生率:27.4％(419/1 528)比7.3％(423/5 758);粘连型:18.0％(275/1 528)比5.6％ (322/5 758);植入型:7.9％(121/1 528)比1.4％(83/5 758);穿透型:1.5％(23/1 528)比0.3％(18/5 758)],差异均有统计学意义(P＜0.01).前次剖宫产发生产后出血者再次妊娠胎盘植入的总发生率以及不同胎盘植入类型发生率均较未发生产后出血者明显升高[总发生率:33.9％(74/218)比10.9％ (768/7 068);粘连型:22.5％(49/218)比7.8％(548/7 068);植入型:9.6％(21/218)比2.6％(183/7 068);穿透型:1.8％(4/218)比0.5％(37/7 068)],差异有统计学意义(P＜0.01).而前次剖宫产距本次妊娠间隔时间与三种胎盘植入类型发生率及总发生率比较差异均无统计学意义(P＞0.05).结论 剖宫产术后再次妊娠发生胎盘植入可能与前次剖宫产时中转手术以及产后出血密切相关,剖宫产再次妊娠者应加强对该类孕妇的孕期管理.“,”Objective To analyze the correlation between different types of placental implantation after cesarean section and previous cesarean section.Methods The data of 7 286 pregnant women with second pregnancy after cesarean section from January 2010 to October 2018 were retrospectively analyzed.Among them,842 cases had placental implantation.Five hundred and ninetyseven cases were adhesion type,204 cases were implantation type and 41 cases were penetration type.The relationship between the type of placental implantation in this pregnancy and emergency operation and postpartum hemorrhage during previous cesarean section and the time from this pregnancy was analyzed.Results The total incidence of placental implantation and the incidence of three types of placental implantation in the transfer operation group was higher than that of non-transfer operation group,total:27.4％ (419/1528) vs.7.3％ (423/5 758);adhesion type:18.0％ (275/1 528) vs.5.6％ (322/5 758);implantation type:7.9％ (121/1 528) vs.1.4％ (83/5 758);penetration type:1.5％ (23/1 528)vs.0.3％ (18/5 758),and there were significant differences (P＜0.01).The total incidence of placental implantation and the incidence of three types of placental implantation in postpartum hemorrhage group was higher than that in the non-postpartum hemorrhage group,total:33.9％ (74/218) vs.10.9％ (768/7 068);adhesion type:22.5％ (49/218) vs.7.8％ (548/7 068);implantation type:9.6％ (21/218) vs.2.6％ (183/7 068);penetration type:1.8％ (4/218) vs.0.5％ (37/7 068),and there were significant differences (P＜0.01).There was no statistical significance between the time of pregnancy and the incidence and total incidence of three types of placental implantation (P＞0.05).Conclusions Placental implantation after cesarean section may be closely related to emergency operation and postpartum hemorrhage during the previous cesarean section.Pregnant women with second pregnancy after cesarean section should strengthen the management of pregnancy.