Clinical Analysis Of 197 Cesarean Scar Uterus Pregnant Women With Pernicious Placenta Previa

ObjectiveTo explore the influence of cesarean scar uterus with pernicious placenta previa and the different courses of the cesarean on maternal and perinatal babies, and we retrospectively analyzed the clinical data of scarred uterus gravidas with placenta previa.Methods:Clinical data of 197 cases of scarred uterus with placenta previa, who delivered from January 2014 to June 2015 in the Department of Obstetrics of the First Affiliated Hospital of Chongqing Medical University, Chongqing maternity and child care and the emergency center of Chongqing, was retrospectively analyzed. Comparisons among the cases on general condition, changes during operation,as well as maternal and fetal outcome were also performed. According to the dangerous degree of the disease can be divided into: the patients with placenta previa dangerous and non dangerous placenta previa; according to the previous cesarean delivery reason is divided into: elective cesarean delivery and failure vaginal delivery.Results:The gravidity, rate of premature infant, recurrent cavity surgery and antenatal hemorrhage of pernicious pregnant women[4.82±1.503, 42.1%, 98.7%, 73.7%] were significantly higher than those of non-pernicious pregnant women[3.97 ± 1.231, 15.7%, 88.4%, 29.8%](P<0.05). Comparisons between pernicious and non-pernicious group on the rates of postpartum hemorrhage, placental implantation, DIC, hysterectomy and NICU occupancy of newborns were 34.2% vs3.3%, 67.1% vs 24.8%, 9.2% vs 0.8%, 23.1% vs 0%, 28.9% vs 5.8%, respectively(P<0.05), showing a significant rising in the former group. Pernicious placenta previa was more likely to appear in subsequent pregnancy women who received a cesarean after a failure of vaginal delivering was,(P<0.05). The pernicious group with previous cesarean after failure vaginal delivering significantly outnumbered the non-pernicious group upon the rates of placental implantation, postpartum hemorrhage, postpartum massive hemorrhage, hysterorrhexis, hysterectomy, DIC, blood transfusion, neonatal asphyxia, NICU occupancy, and perinatal death(P<0.05).Conclusion:The risk of pregnancy complicated with pernicious placenta previa in previous elective cesarean delivery group was significantly higher than previous cesarean after failure vaginal delivery group. And the maternal and neonatal results were also worse in the previous elective cesarean delivery group. It is vital to control the indications of the first cesarean in order to improve the re-pregnant outcomes.