| Backgrounds：The placenta implantation belongs to the category of pregnancy-related hemorrhagicdiseases, the incidence and severity rising in recent years. To prevent the potentialcomplication of intractable hemorrhage, in addition to the perinatal hysterectomy, uterineartery embolization can be as a new method to replace surgery, and has been proved thesuccess rate in controling postpartum hemorrhage more than90%. In this study，weanalyzed the clinical characteristics of placenta implantation, explored the clinical efficacy，complications, and influence on future fertility for uterine artery embolization treatingplacenta implantation.Purpose：To explore the clinical features, diagnosis，complications and curative effects ofuterine artery embolization (UAE) on patients with placenta accrete.Methods：We reviewed and analyzed the clinical outcome, effective rate (such asbleeding reduction or stop, menses return and re-pregnancy), and ineffective rate (such asadditional embolization treatment, hysterectomy, and maternal death) of embolizationtreatment in the80late pregnancy cases of110placenta accreta cases (40cases in UAEgroup,9cases in hysterectomy group,12cases in conservative treatment group, and19eliminated cases) hospitalized in Xinqiao hospital from January,2006to December,2012.1. General information collection：Embolization treatment in the80late pregnancycases of110placenta accreta cases (40cases in UAE group,9cases in hysterectomy group,12cases in conservative treatment group, and19eliminated cases) hospitalized in Xinqiaohospital from January,2006to December,2012. 2. The data observing and recording：We reviewed and analyzed the clinical outcome,effective rate (such as bleeding reduction or stop, menses return and re-pregnancy), andineffective rate (such as additional embolization treatment, hysterectomy, and maternaldeath) in three groups. Get information about menstruation and fertility for patients bytelephone follow-up, and record normal menstruation and pregnancies again during theclinical follow-up of1year.3. Statistics analysis: Applicate of SPSS19.0software for statistical analysis,measurement data using t test and variance analysis. P <0.05for the difference wasstatistically significant.Result：1. The occurrence of placenta implantation is related to the patient’s history ofcesarean section (38.18%), curettage history(92.73%), placenta previa (32.73%), and age(30.00%). Diagnosis depends on three basis： clinical manifestations, color dopplerultrasound examination and pathologic examination.2. There was no statistical significance of age, gestational weeks, times of pregnancyamong the three groups (P>0.05).3. After UAE, bleeding in38cases were successfully arrested, but2cases failed.There were common complications such as fever and abdominal pain, but no organischemia and nerve damage.4. The differences of blood loss and blood transfusion, operation time, andhospitalization time among the three groups had statistical significance (P<0.05).5. One year follow-up was performed for the patients in the UAE group. Except for9lost patients during follow-up,31patients resumed normal menstruation and two of themwere pregnant again.Conclusion：1. The incidence of placenta implantation has increased over time. The diagnosis ofplacenta implantation is given priority to clinical diagnosis and color doppler ultrasounddiagnosis. 2. UAE has the advantages of short time of pre-operative preparation and operation,rapid bleeding control and reduced complications, and avoid hysterectomy to improve lifequality of patients. |
