The Bad Outcomes Of Mother And Child And The Management Of Pernicious Placenta Previa

Objective:By analyzing the clinical data of the patient who is with Pernicious Placenta Previa(PPP),to explore the effects of PPP and the importance of the management of PPP.Methods:68 patients with PPP treated in Dalian Maternal and Child Health Care Hospital affiliated to Dalian Medical University from January in 2012 to December in 2016 were selected as research objects.According to placental implantation,divided into group A(with placenta increta,n=33)and group B(without placenta increta n=35).According to the timing of surgery,divided into group C(elective surgery,n=33)and group B(emergency surgery,n=35).Results:1.Nearly five years,the proportions of secondary pregnancy of women with a scarred uterus rises year by year,the morbidity of PPP rises year by year too.By 2016 the morbidity of PPP up to 0.16%,about 8 times higher than 2012.2.Age<35 years old more than>35 years old a(60.29%/39.71%).The number of patients who had a abortion is 54(79.45%),14 patients never done abortion(20.59%).Cesarean section interval 5-10 years(50.00%)more than<5 years(23.53%)and?10years(26.47%).3.Blood loss and blood product use rate of group A was higher than group B,the differences between the two groups were statistically significant(p<0.05).The differences of Blood loss and Blood Product use Rate between group D and group C,had no statistically significant(P>0.05)?4.The Incidence rate of Postpartum Hemorrhage,Hemorrhagic shock,DIC,Hysterectomy and Puerperal Infection of group A higher than group B,the differences between the two groups were statistically significant(P<0.05).Prolonged the gestational age could lead to increase the Incidence rate of Postpartum hemorrhage(R=0.926,P=0.00).the differences of Incidence rate of Postpartum hemorrhage,DIC,Bladder injury,Hysterectomy and Puerperal Infection between group D and group C had no statistically significant(P>0.05).The Incidence rate of Hemorrhagic shock in group D higher than group C,the differences between the two groups were statistically significant(P<0.05).5.The differences of the Incidence rate of Preterm birth and Newborns were transferred to NICU,Neonatal complications and Birth weight between group A and group B,had no statistically significant(P>0.05).The differences of the Incidence rate of Preterm birth and Newborns were transferred to NICU and Neonatal complications between group D and group C,had no statistically significant(P>0.05).Conclusions:1.The incidence of PPP increased year by year.2.PPP has a higher risk in placenta increta,When accompanied by placenta accreta is more prone to intractable bleeding,result in Postpartum Hemorrhage,Hemorrhagic Shock,DIC,Hysterectomy and Puereral Infection.3.Elective surgery for PPP is the best choice.When PPP accompanied by placenta increta,could consider that Terminate pregnancy before 36 weeks,if prolonged delivery of gestational age,Postpartum Hemorrhage significantly increased.