Clinical Analysis Of19Cases Of Late Pregnancy With Pernicious Placenta Precia

Objective:To investigate and analyze the clinical characteristics of patients with pernicious placenta previa, maternal and neonatal outcomes, and its treatment of pregnancy termination.Methods:We collected and analyzed retrospectively the clinic data of19patients with pernicious placenta previa in maternity ward, the first affiliated hospital of Dalian Medical University from Jan,2009to Dec,2013, which was divided into Group placenta increta and Group placenta non-increta. All data was processed by SPSSI9.0version statistical software. The normal distribution of measurement data was expressed as x±s, and the average of two groups was compared by T test. The non-normal distribution of measurement date was expressed by using the median and inter-quartile spacing (QR). Fisher’s exact probability method was used to compare the counting data. The difference P<0.05was statistically significant.Results:1. In recent5years, the incidence of pernicious placenta previa was2.8‰(19/6889) in our hospital, the cases combined with placenta increta was36.8%(7/19). There was no statistical difference between Group increta and Group non-increta on age, times of being pregnant (P>0.05). There was no statistical difference between Group increta and Group non-increta on past cesarean delivery (P>0.05). There was no statistical difference between Group increta and Group non-increta on gestational age with vaginal bleeding and blood loss during operation (P>0.05). There was statistical difference between Group increta and Group non-increta in the amount of blood transfusion (P=0.001). There was no statistical difference between Group increta and Group non-increta on operation time.2. The pregnant women in Group increta had a large amount of blooding during operation (P=0.000), and had more cases of hysterectomy and secondary coagulation disorders (P=0.000), and which was easy to cause injury of bladder in operation. In Group increta, newborn babies had high incidence of complications, high rates of being in NICU and long time to stay in hospital.3. For treatment of pernicious placenta previa, it would choose different operative plan according to the particular case during operation. In Group increta, there was2cases of subtotal hysterectomy, one of the two repairing the bladder at the same time;1case of total hysterectomy;4cases of remaining uterus. In Group non-increta, the total cases had remained uterus. Conclusion:1. We should try ours best to reduce the first cesarean section with no obstetrical indications, which could reduce the incidence of pernicious placenta previa radically.2. Pernicious placenta precia with placenta increta is easy to cause severe maternal and neonatal complication. To make the accurate diagnosis during pregnancy as early as possible and take the individualized and multidisciplinary combination therapy are very important to improve maternal and neonatal outcomes.3、During the operation in the patients of pernicious placenta previa combined with placenta increta, it is necessary to take decisive hysterectomy in order to save maternal life if uterine bleeding is not under control.