The Therapy Of Complete Placenta Previa Complicating Accreta

BackgroundAfter the28th week of gestation, the placenta attached to the lower uterinesegment, even reach or over intracervical mouth, its position is under the fetalpresentation, called placenta previa. Placenta previa especially complete placentaprevia is the important reason of the massive blood loss of the gravidas in thirdtrimester especially in deliverry. And with the increase of the cesarean section rate,the amount of the patients with the complete placenta previa complicating placentaincreta is increasing. The bleeding volume in cesarean section of the patients withplacenta implantation increases significantly, and the uterus resection rate and deathrate is higher when the pregnant woman gives birth to a child. Therefore, seeking anew method of the termination of pregnancy, to reduce intra-postoperative bleedingvolume of the cesarean section, to reduce the uterus resection rate and mortality rateof pregnant women, is now a important topic of the obstetric medical research. Thispaper aims to discuss a new surgical method of cesarean delivery in the treatment ofcomplete placenta previa complicating placenta implantation,which is carried out inthe first affiliated hospital of zhengzhou university. ObjectiveThrough a retrospective comparison and analysis, to investigate differentcesarean delivery methods in the complete placenta previa complicating placentaincreta,to explore the clinical application value of the new cesarean delivery methodin the patients with complete placenta previa complicating placenta implantation.Materials and MethodsRetrospective study32late pregnancy patients with placenta previacomplicating placenta increta in the first affiliated hospital of zhengzhou universitybetween January2010and November2013,21cases with traditional cesarean sectionto termination pregnancy, known as A group;11patients with new surgery method,cesarean delivery+uterine artery embolization, carried out by the department ofobstetrics and interventional radiology in the DSA operating room, called group B.We compared the difference of neonatal and maternal outcome between the two kindsof surgical method. All data were presented as mean±standard. Statistical test wasperformed using χ2test t test or t,test. Results were considered statistically significantif P value was less than0.05. Statistical process was used by SPSS19.0for Windowssoftware.Results(1)The birth weight of newborn babies,5min APgar score group B was higherthan that of group A;1min APgar score group A was higher than group B, but therewas no statistically significant difference (P>0.05). The neonatal NICU transfer rateand mortality had no significant difference (P>0.05) between group A and B.(2) The postpartum blood loss of group A and group B, group A is significantlyhigher than group B, the difference was statistically significant (P <0.01).Thematernal hysterectomy rate, postoperative ICU transfer rate, puerperal infection rateand maternal mortality rate had no significant difference (P>0.05) between group A and B.ConclusionThe new method of operation, cesarean delivery+uterine artery embolization,carried out by the department of obstetrics and interventional radiology in the DSAoperating room., can not only reduce the amount of the blood loss of the caesareanbut reduce the rate of hysterectomy. Terefore, the new operation mode can make thepregnant women’s life get stronger operation，make the delivery women recoveryfaster. And the quality of life of the delivery women can be improved obviously.