The Treatment Of Pernicious And Normal Placenta Previa And The Correlation With The Pregnancy Outcome

Objective:Use the case-control method to analyze the general situation of pernicious placenta previa in order to know the risk factors of it.Analysis the change of perioprative management of pernicious and normal placenta previa in xiangya hospital to find the correlation with pregnancy outcome.Method:Using case-control study to research the patients from xiangya hospital from January,2011to December2013,among which100were pernicious placenta previa,245cases were normal placenta previa. Information including general condition,clinical characteristic, periop-erative management and neonatal outcomes were analyzed.Result:1.Single factor analysis showed that gravity, parity, residence,times of cesarean delivery,in vitro fertilization,times of abortion, degree of education were influencing factors of pernicious placenta previa.A further multiple-factor logistic regression confirmed that the risk factor of pernicious placenta previa was times of cesarean delivery.OR=20.294.2.Pernicious placeenta previa has high rates in placenta accreta compared with normal placenta previa (P<0.05). Ultrasound is the main auxiliary tool to diagnosis placenta accreta.3.in2011-2013,patients with placenta previa in our hospital increased year by year,compared with2011,pernicious placenta previa in2013increased 12times and normal placenta previa increased60%.4.There was no statistically difference in termination time, preoperative and postoperative hemoglobin between patients with placenta previa from2011to2013(P>0.05).5.There was significant difference in uterine artery interventional embolization, intrauterine packing with gauze in patients with placenta previa from2011to2013(P<0.05),also there was significant difference in the rate of hysterectomy,the amount of blood loss,blood transfusion in pernicious placenta previa(P<0.05).6.patients with placenta previa had no different effect on neonatal outcome from2011to2013(P>0.05).Conclusion:1.Pernicious placenta previa is affected by times of cesarean delivery.2. Pernicious placenta previa had higher rate in placenta accreta,ultrasound is the main auxiliary to diagnosis the placenta accreta.3. The incidence of placenta previa,especially the pernicious increased significantly from2011to2013.4.The progress of the perioperative management and the application of lower uterine segment ring strapping make the rate of hysterectomy,the amount of postpartum bleeding,blood transfusion of pernicious placenta decreasing obviously.