Scar Uterus Placenta Previa Maternal And Neonatal Clinical Outcomes Study

Objective:To investigate scar uterus placenta previa the clinical characteristics and treatment methods and timingMethods:A retrospective analysis from January 2012 to December 2014 Yangzhou University Clinical Medical Hospital of 42 cases of uterine scar merger placenta previa (the study group) and 57 cases of patients with placenta previa first cesarean delivery (control group) were compared.ReSUltS:99 patients were confirmed by caesarean delivery to terminate the pregnancy, the study group of patients with premature 27 cases (64.3%), the mean operative time (78.5 ±51.6 min), mean blood loss (1033±1116.5 ml), hysterectomy five cases (11.9%), blood transfusion (including Packed red blood cells and Fresh frozen plasma)17 cases (40.5%), placenta accreta(PP) 8 cases (19.0%), in the control group,29 cases of patients with preterm labor (50.9%), the mean operative time (49.9 ± 14.3 min), mean blood (448 ±311.4ml), one case of hysterectomy (1.8%), blood transfusion(including PRBC and FFP) 6 cases (10.5%),3 cases of placenta accreta (5.3%). Study group than the control group operation for a long time, postpartum hemorrhage volume, the difference was statistically significant (P<0.05). The number of cases of transfusion research group, placenta accreta, hysterectomy incidence rate higher, the difference was statistically significant (P<0.05).There were no significant difference in the gestational age and birth between the anterior wall and the posterior wall (P> 0.05); the anterior wall of placenta previa and uterine scar average pregnancies were significantly higher than the posterior wall (P<0.05); anterior wall have a high percent of complete placenta previa, The operation time of the front wall of placenta previa, postpartum bleeding more than wall, a higher incidence of neonatal asphyxia, the difference was statistically significant (P> 0.05).Study Group 27 cases of neonatal preterm (64.3%), neonatal asphyxia in 3 patients (7.1%), two cases of neonatal death (4.8%); the control group 29 cases of neonatal preterm (50.9%), neonatal asphyxia 3 patients (5.3%), one case of neonatal death (1.8%); two sets of data on the chi-square test (P> 0.05), no significant difference between the two groups.Conclusions:1. placenta previa with previous cesarean delivery as cesarean delivery increased year by year;2. placenta previa with previous cesarean delivery serious harm:long operation time, blood volume, prone to placenta accreta, the high incidence of transfusion therapy, uterine packing gauze, suture local conservative therapy, hysterectomy rates and other indicators;The anterior wall of placenta previa than the posterior wall with the high uterine scar,are more likely to produce adverse clinical outcomes;3. placenta previa with previous cesarean delivery bigger harm to maternal and neonate, we should be clear in prenatal diagnosis, good prenatal care, Perioperative take timely and accurate processing, which will reduce the minimum maternal injury, we should all fronts efforts to reduce the rate of cesarean delivery.