The Clinical Study Of Placenta Accreta For Maternal And Perinatal Fetus

Objective:The research is designed to investigate pathogenic factors, the incidence of treatment, prenatal diagnosis, delivery time, preoperative preparation and measures of treatment of placenta accreta. Then, I can further explore the effect of concomitant placenta previa of placenta accreta and pregnancy outcome, expecting to provide reference for the clinical diagnosis and treatment work.Method:There were 34649 pregnant women in Subei people’s Hospital of Obstetrics and Gynecology Yangzhou Maternal and Child Health-Care Center of Yangzhou city from 2011 January to 2014 September, which are level three hospitals.47 patients with placenta accreta were selected whose clinical treatment is retrospectively analyzed. Patients were divided into two groups based on the last ultrasound diagnosis which showed placenta previa, which are the group of complicated placenta previa and the group of non-complicated with placenta previa. Effects of postpartum hemorrhage, blood transfusion, preoperative hemoglobin, postoperative hemoglobin, into ICU care, infection, blood coagulation dysfunction, urinary system injury, the average number of days of hospitalization and infant outcomes on patients with placenta accreta and placenta previa are analyzed.Result:(1)To study the incidence of placenta accreta from Statistics of the year of 2011,2012, 2013,2014, I find the annual incidence rate of placenta accreta rising year by year. (2) Compared the two groups about mode of delivery, there was statistically significant difference (P=0.009), the patients of placenta previa were taken cesarean section. (3)The average amount of bleeding of elective surgery was 1278.26 milliliter; average amount of bleeding of emergency operation was about 1579.41 milliliter. (4)There existed a linear correlation between manual removal of placenta and postpartum hemorrhage (P=0.03). (5)To compare postpartum hemorrhage, blood transfusion, rate of blood coagulation dysfunction, rate of transferring to the intensive care unit, rate of peripartum hysterectomy between patients of the two groups, the difference were statistically significant (P=0.004,0.006,0.01,0.04,0.02). (6)The two groups of preoperative and postoperative hemoglobin were compared, the difference was statistically significant (P<0.001). (7)Neonatal Apgarl score, Apgar5 score, the incidence rate of low birth weight premature, the rate of stillbirth, the rate of transferring to the neonatal intensive care unit between two groups were compared, the difference were not statistically significant (P=0.54,0.40,0.23,1,0.06).Conclusion:1.With the increase of the risk factors of placenta implantation, such as artificial abortion rate and cesarean section rate, incidence of placenta implantation rate increased obviously, we need to reduce the control intervention operation in order to reduce incidence of placenta accreta.2. When we found it was difficult to remove the adherent placenta from intrauterine, we do not forcibly remove the placenta and should consider interventional therapy or hysterectomy. Otherwise, removal of the adherent placenta may cause the postpartum hemorrhage.3. On the placenta accreta complicated with placenta previa, we need to strengthen the prenatal diagnosis of early placental accreta and reasonable expectant management, pay attention to treatment of perioperation, rescue of postpartum hemorrhage and other sectors. Then it can reduce the incidence of serious complications, and improve the prognosis of mothers and infants.