Correlation Of The Placenta Attached Position And Placental Migration

Objective To research relationship of the placenta attached position and placentalmigration in the second trimester, different types of placenta previa state situationoutcome, the choice of the mode of delivery, plcenta previa complications to theinfluence of the mother and son,and the accuracy of ultrasound placenta previa typejudgment,through continuous observation of the different locations placenta byultrasound.Thus placental migration can be evaluated and predicted objectively,a betterbasis is provided on the clinical diagnosis and treatment of placenta previa timely.Methods128cases of pregnant women were selected at18to24weeks of pregnancy,they were asked to appropriate filling the bladder, so that bladder capacity wascontrolled at50-150ml.The coverage area of placenta was observed,the lower edge ofthe placenta and the internal cervical os distance was measured through transabdominalsonography（TAS）.They were divided into the anterior wall group （group A）, theposterior wall group （group B）, the sidewall group （group C） and mixed wall group（group D）, according to the placenta covering the area. And56cases of pregnantwomen of placenta previa status were divided into four groups of complete, partial,marginal, low-lying state. If the location of the placenta was low and placenta wasshowed unclear through transabdominal sonography, transperineal ultrasound（TPS） wasused further.Ultrasound examination was repeated every four weeks until38～40weeksof pregnancy. The placenta average migration speed（v） was calculated:v=△d/4（△dwas change value of the lower edge of placenta and internal cervical os distance）.Thenthe migration rate of placentas（v）was calculated after follow-up: v=（v₁+v₂+v₃+v₄）/4or （v₁+v₂++v₅）/5.Then we analyzed covering the different areas of the placentalmigration rate difference whether there were statistically significant. At the same timedifferent types of placenta previa state situation outcome were compared. The maternitysituation and intrapartum placental position were followed up finally.Results The placenta attached to a different location in the second trimester,themigration degree was also different. A, B, C, D four groups placenta migration rate werecompared, in addition to A and B group （P <0.05）,the other groups were no statisticalsignificance.Placenta previa state has varying degrees of outcome from the second trimester to thethird trimester.56cases of placenta previa in the second trimester had different degreesof outcome to the third trimester of pregnancy.Low-lying state placenta turned over tothe highest ratio,while complete placenta previa turned over to the minimum.15casesout of16cases of low-lying placenta outcome to its normal position,while only one ofthe twelve cases of complete placenta previa went to the normal position. Ultrasonicdiagnosis coincidence rate reached98%at delivery.In the follow-up process we foundplacenta previa can cause vaginal painless bleeding in late pregnancy, and produce avariety of complications, and even endanger the life of the mother and child. Differenttypes of placenta previa clinical treatment were different, prenatal ultrasound diagnosisof placenta previa and its type was accurate and reliable, able to provide reliable, directbasis for clinical guidance pregnancy to choose their mode of delivery.Conclusions1. The placenta attached to a different location in the second trimester,themigration degree was also different. Anterior wall placenta migrates faster thanposterior wall placenta, the other groups were no statistical significance.2. Placenta previa state has varying degrees of outcome from the second trimester to thethird trimester. Therefore it should not be to diagnose placenta previa too early. 3. The distance of placental lower edge and internal cervical os and coverage area ofplacenta are important factors to affect the migration of placenta.They are the importantfactors for antepartum hemorrhage and other complications, and important basis for theclinical selection of mode of delivery.4. Ultrasonography is noninvasive, simple, accurate,et al, and it is the first choice ofplacenta localization, the qualitative check method.