Analysis Of80Cases Of Placenta Previa In Patients With Risk Factors Of Postpartum Hemorrhage

Objective: Analysis of pregnancy complicated by placenta previa using clinicaldata of patients with placenta previa, explore the risk factors of postpartum hemorrhageand its prevention at the first affiliated hospital of Dalian Medical University in the pastten years.Methods: Retrospective analysis of hospitalized80cases of placenta previa duringchildbirth, with risk factors of postpartum hemorrhage and pregnancy outcome at theFirst Affiliated Hospital of Dalian Medical University for ten years from January2002January to December2011. Out of80cases patients with placenta previa: the number ofcases was20,10, and50for the marginal placental previa,Partial placenta previa, andthe central type of placenta previa respectively.Patients aged22to44years old, with anaverage age of (31.2±4.01). Pregnancy history: Primipara29cases and Multipara51cases (10cases of vaginal birth history and the history of cesarean section in11cases);The history of artificial abortion in44cases: including18once,18cases twice, thricein6cases, forth times or more in2cases.Data was analyzed retrospectively.UsingSPSS17.0software,Using Excell to establish database, count data using X2test, P <0.05,the difference was statistically significant.Results:1. Pregnant women with placenta previa was divided in two groups;<35yearsand≥35years of age with65cases and15cases respectively. The two groups werecompaired in relation to postpartum hemorrhage, the results show that maternal ageand the amount of bleeding unrelated (P>0.05).2. According to the times of pregnancy, which can be divided into1timepregnancy and≥2times, the former29cases, accounting for36.25%of the total, therate of postpartum hemorrhage was34.5%; the latter51cases, accounting for63.75%ofthe total, the rate of postpartum hemorrhage for54.5%.The results show, the number of pregnant women with pregnancy and postpartum hemorrhage unrelated,(P>0.05), butthe pregnancy is more than2times the rate of postpartum hemorrhage was significantlygreater than1times of pregnancy.3.The group had a history of cesarean section in11cases, accounting for13.75%of the total, postpartum hemorrhage rate was90.9%; no history of cesarean section in69cases, accounting for86.25%of the total, postpartum hemorrhage rate was39.1%,compared to two there is a significant difference,(P <0.05).4. This group of50patients with central type of placenta previa, postpartumhemorrhage rate58%; marginal placenta previa in20cases, the rate of postpartumhemorrhage was20%; partial placenta previa in10cases, the rate of postpartumhemorrhage40%.The central type of placenta previa postpartum hemorrhagesignificantly more than the part and the edge, P <0.05.5. In80cases of placenta previa patients,18cases complicated with PlacentaAdhesion and (or) implantation, accounted for22.5%, the rate of postpartumhemorrhage was83.3%; not complicated with Placenta Adhesion and (or) implantationin62cases, accounting for77.5%, the rate of postpartum hemorrhage for35.4%.Placenta Adhesion and (or) implant recipients of postpartum hemorrhage volumeincreased significantly, P <0.05.6. Maternal and fetal outcomes in pregnant women:80cases survived,7patientswith central type of placenta previa bleeding, after various hemostatic methods invalidconservative treatment, hysterectomy.80cases of perinatal,2cases of fetalmalformation, because the central type of placenta previa in mid pregnancy, Caesareanbirth; in12cases32weeks and35weeks gestation intrauterine fetal death, Caesareanbirth,1cases of pregnancy trimester labor induction, the remaining75cases survived.7. The team found5cases of pernicious placenta previa, after the rescue ofmaternal and neonatal survival.Conclusion：1. Of all patients delivered at our hospital for the past ten years,placenta previaaccounted for0.69%(80cases).The postpartum hemorrhage rate was46.25%;complicated with Placenta Adhesion or implants in18patients, the incidence of22.5%;dangerous placenta previa in5cases, the incidence of6.25%; the rate of hysterectomyin8.75%.2. Risk factors for postpartum hemorrhage in patients with placenta previa are;the history of cesarean section, the central type of placenta previa, placenta adhesion, or implant.3. Pernicious placenta previa cause a serious harm to mother and infant health andlife, should cause height to take seriously, advocate natural childbirth, control theindications for cesarean section.