Prenatal Ultrasound In Late Pregnancy Bleeding Pregnancy Outcomes

Background and objectiveBleeding in late pregnancy,also known as antepartum hemorrhage（Antepartumhemorrhage,APH）, Refers to the20weeks of pregnancy, or28weeks after the birthof vaginal bleeding is more common obstetric emergencies in recent years, theamount of bleeding, ranging from less to more, is associated with maternal and fetalmorbidity and mortality are closely correlated, increase the rate of preterm birth,cesarean section rate and hysterectomy rates and other adverse pregnancy outcomes,maternal mortality and stillbirth in particular, can lead to bleeding is heavy.Bleeding if not controlled can develop heavy bleeding, although modern obstetrictechniques and the increasing popularity of transfusion, bleeding is still an importantcause of maternal and fetal morbidity and mortality. Bleeding in late pregnancyshould focus on the primary management stage and accurate diagnosis, prenatalultrasound examination can diagnose the most timely and accurate causes of bleeding,control bleeding, reduce adverse pregnancy outcomes is particularly important,especially the rapid development of transvaginal ultrasound, with further improve the accuracy of diagnosis, so in recent years, ultrasound has been considered as the firstchoice causes of bleeding in late pregnancy diagnosis.Bleeding in late pregnancy increased incidence in our country every year, manyand complex causes of bleeding, but few studies abroad in late pregnancy to make amore comprehensive analysis of the causes of bleeding, and there was little literatureevaluation of prenatal ultrasound in reducing late pregnancy bleeding adversepregnancy outcomes in importance.The purpose of this study was to:1, mainly due to bleeding in late pregnancyand pregnancy outcomes for a more comprehensive summary of the analysis;2, todiscuss the important role of prenatal ultrasound in reducing bleeding in latepregnancy adverse pregnancy outcomes and easy to play factors leading to prenatalultrasound missed.Subjects and Methods1, selected from May2010-October2012in the third trimester of pregnancy,Second Affiliated Hospital of Zhengzhou University, over the same period incomepregnant women and hospitalized a total of2573cases of expectant women,20-40weeks gestational age19-40years, mean29years old, all pregnant women in ourhospital were established Wai Bao file and produced in our hospital.2573cases ofpregnant women had one or more vaginal bleeding history? Cases will be referred tohemorrhage, and the rest? Cases of pregnant women to the end of pregnancy had novaginal bleeding, referred to as non-bleeding group.2573cases of pregnant womenin our hospital were carried ultrasound, first of all, a routine examination fetus and itsappendages, and then check the placenta targeted shape, location, gap placenta aftercesarean section scar, cervix surrounding tissue. On the edge of the mouth of thecervix relations under the placenta Show dissatisfied supplemented by transvaginalultrasound or transperineal ultrasound, prenatal ultrasound examination in all casesof postpartum clinical results combined analysis of causes of bleeding.2,2573casesof pregnant women were followed up until the end of pregnancy, to collect theirpregnancy outcome;3, discussed the importance of prenatal ultrasound in latepregnancy bleeding pregnancy outcomes and maternal factors easily lead tomisdiagnosis of prenatal ultrasound.4Statistical Methods: Measurement data (mean ±standard deviation) were analyzed using statistical software SPSS17.0between thetwo groups were compared using t test was used to compare the rate of inspection toP <0.05was considered statistically significant.)ResultsThe reason a lot of bleeding in late pregnancy can be divided into local factorsand systemic factors, including local factors and obstetric factors and non-obstetricfactors. Obstetric factors include placenta previa, placenta accreta, placentalabruption, placenta edge sinus rupture, placental tumors, umbilical cord front, uterinerupture, non-obstetric factors include cervical incompetence, cervical lesions(cervical erosion, cervical polyp, cancer etc.), uterine fibroids, vaginal diseases(vaginal venous plexus rupture, vaginal lacerations, etc.). Systemic factors include:coagulation disorders, vascular diseases. One of the most common followed byplacenta previa, placental abruption, placenta accreta. Adverse pregnancy outcomesfor the mother and can be divided into two categories on the fetus. Occurred inadverse pregnancy outcomes, including maternal: intrapartum hemorrhage,postpartum hemorrhage, hysterectomy, puerperal infection, amniotic fluidembolism, disseminated intravascular coagulation (DIC) and coagulation disorders,thrombophlebitis, acute renal failure; occurs in fetal adverse pregnancy outcomes,including: prematurity, perinatal death, low birth weight children, fetal distress,neonatal asphyxia, neonatal hypoxic-ischemic encephalopathy, hyperbilirubinemiaand so on. Group in late pregnancy bleeding bad pregnancy outcome incidence ofbleeding was significantly higher than those without, the difference was statisticallysignificant (P <0.05).Conclusion1, mainly due to late pregnancy bleeding placental abnormalities, in turn,including placenta previa, placental abruption, placenta accreta.2, pregnant women in late pregnancy bleeding incidence of adverse pregnancyoutcomes compared with normal pregnancy significantly improve maternal, prenatalultrasound timely and correct diagnosis of the cause of bleeding may be reasonablefor clinical intervention, management and selection of the mode of productionprovides an important basis to prevent some adverse pregnancy outcome of bleeding in late pregnancy is important.