Clinical Analysis Of30Cases Of Pernicious Placenta Previa In Late Pregnancy

Objective: To investigate the clinical characteristics, outcomes of maternal and neonatal,treatments of patients with pernicious placenta previain in late pregnancy.Methods:30cases of late pregnancy with pernicious placenta previa in FujianProvincial Hospital from2008January to2012December were included,which were divided into placenta implantation group and non-placentaimplantation group according to the clinical diagnosis and pathologicaldiagnosis. Thereafter, clinical characteristics, outcomes of maternal andneonatal, treatments of patients in the two groups were investigatedretrospectively.Results: The pernicious placenta previain morbidity was2.2‰in Fujian ProvincialHospital from2008January to2012December, among which with placentaimplatation was1.2‰. The age and previous pregnancies had no significantdifference between implantation group and non-implantation group(P>0.05).However, compared with non-implantation group, implantation group hadmore previous cesarean section number(P=0.01). The vaginal bleeding timeand vaginal bleeding volume had no statistical differences(P>0.05). Theultrasound diagnosis rate was96.3%, among which the implantation groupwas23.1%.The MRI diagnosis rate was100%among which the implantationgroup was85.7%. No significant differences were observed in implantationgroup and non-implantation group in AFP value(P>0.05). Compared withnon-implantation group, implantation group had more postpartumhemorrhage amount, more cases of uterus removal, more incidence rates ofDIC(P<0.05),and more cases of bladder injury. There were no statistical differences in the termination of pregnancy and neonatal weight and1min inApgar score(P>0.05).However, the neonates of implantation group hadmore complications, longer NICU hospitalization. For the treatment, theways of operation depended on different situations. In the implantation group:4cases of uterine preservation operation,12cases of hysterectomy.3casesin the implantation group underwent interventional therapy. In the non-implantation group:13cases of uterine preservation operation,1case ofhysterectomy. All the patients were cured and discharged.Conclusion: With the increase number of previous cesarean section, the incident rate ofpernicious placenta previa increased. The clinical manifestations ofimplantation among pernicious placenta previa is no specific. Ultrasound andMRI can improve the diagnosis rate of pernicious placenta previa. Thetreatment of pernicious placenta previa should be combined with the prenataldiagnosis, multiple departments of medical team work and the patients’ willto low the maternal and child risk. Interventional therapy in the perniciousplacenta previa caesarean operation is considered to be a promising treatment,which could help to lower bleeding and to preserve the uterus.