Clinical Analysis Of 90 Cases About The Pernicious Placenta Previa

Objective: We retrospectively analyzed the clinical data of patients with pernicious placenta previa(PPP),analyzed the relevant risk factors and the outcome of the mother and child,and provided reference for the clinical work of obstetrics.Methods: Retrospective analysis of January 2010 to December 2016 in our hospital obstetrics hospitalization and childbirth of the pernicious placenta previa in pregnant women(n=90),and randomly selected the same period of hospitalization without cesarean section of the general placenta of pregnant women as control group(n=181),to terminate the pregnancy before the last ultrasound,magnetic resonance imaging(MRI)examination results or postpartum examination of the relationship between the placenta and the rupture of the membranes for the diagnostic criteria,while excluding normal delivery,twin pregnancy,labor or cesarean section of pregnant women.Comparison of the two groups in general and maternal and child outcomes,while the dangerous group in the relevant circumstances of the group were compared for future clinical work to provide a reference.Results:(1)There were significant differences between age group,gestational age,birth rate and abortion in the pernicious group and the control group(P<0.01),the age of the pernicious group was significantly higher than that of the control group,the birth rate was significantly more than the control group,abortion was significantly more than the control group.There was no statistically difference between the pernicious group and the control group in expecting treatment time and gestational age.(2)The rate of emergency operation,postpartum hemorrhage,postpartum hemorrhage rate,placental increta rate,blood transfusion rate,blood transfusion,hysterectomy rate,postoperative hospital stay and ICU rate were higher than those in the control group(P<0.05).There were significant differences in postpartum hemorrhage,postpartum hemorrhage rate,placental increta rate,blood transfusion,hysterectomy,postoperative hospital stay and ICU rate(P<0.01).There was significant difference between the pernicious group and the control group in the placenta accrete rate(P<0.01).There was no statistically difference between thepernicious group and the control group in the complex cesarean section rate.(3)There was no statistically significant difference between the pernicious group and the control group.(4)The incidence of complete placenta prevailing in the pernicious group was higher than that in the control group,and the incidence of other types was lower than that of the control group,but there was no statistically difference between the two groups.(5)2 cases of cesarean section in patients is higher than 1 cesarean section in patients in the postpartum hemorrhage,postpartum hemorrhage rate,placental increta rate and hysterectomy,and there were statistically differences between the two groups(P<0.05).Which in the hysterectomy rate of the two groups were significantly statistically significant(P<0.01).There was no statistically difference between the two groups in placental accrete rate and gestational age.(6)There was a statistically difference between the complete preoperative placenta group and the non-complete group in the postpartum hemorrhage and placenta increta rate(P<0.05).The complete group was higher than the non-complete group.There was no statistically difference in postpartum hemorrhage rate,placental accrete rate,hysterectomy and gestational age.(7)Abdominal three-dimensional ultrasound in the diagnosis of placenta in the four types of placenta,complete placenta ultrasound diagnosis and clinical diagnosis of the highest coincidence rate of 96.88%,partial placenta previa ultrasound diagnosis and clinical diagnosis of the lowest rate Was77.78%.The total coincidence rate of four kinds of placenta was93.33%.(8)Ultrasound examination of the pernicious placenta previa with placenta increta of the sensitivity of 33.33%,specificity of 34.34%.Ultrasound combined with MRI examination of the pernicious placenta previa with placenta increta of the sensitivity of 90.91%,specificity of 35.29%.Conclusions: 1,Cesarean section history greatly increased the risk of placenta increta,the more the number of cesarean section,the greater the risk of placenta increta,resulting in the more serious adverse pregnancy outcome.2,Cesarean section history,age,multiple pregnancy history can increase the risk of pernicious placenta previa.3,The pernicious placenta previa not only increased the risk of bleeding,hysterectomy,and its high length of stay,turn ICU rate,blood transfusion,etc.,an increase of family and social burden,to the patient and family have caused a larger The trauma.4,The complete placenta previa on the maternal injury than other types.5,In the process of clinical treatment of the pernicious placenta previa,we should payattention to the type of placenta previa,combined with the number of cesarean section and other obstetric risk factors,do a good preoperative assessment to reduce the outcome of adverse pregnancy.6,Should strictly control the indications of cesarean section,reduce the rate of cesarean section in order to reduce the risk from the root of the occurrence of the pernicious placenta previa.