The Influence Factors Of Hysterectomy In Pernicious Placenta Previa

Objective:To analyze the influence factors of hysterectomy in pernicious placenta previa;To discuss the best treatment about pernicious placenta previa.Methods:50 patients with pernicious placenta previa(PPP)whose delivery were taken in the First Affiliated Hospital of Kunming Medical University from January 2015 to March 2017 were collected.19 patients who had hysterectomy were grouped into research group,the otheres were grouped into the control group.Compared the maternal general situation that include age,body mass index(BMI),level of education,gravi.dity history,parity history,and gestational weeks;cesarean section history that include times,placenta previa hi story,where,when,and the neonatal weight;gestation situation that include Gestational Diabetes Mellitus(GDM),Hypertension Disorders Complicating Pergnancy(HDP)and Intrahepatic Cholestasis of Pregnancy(ICP);the condition of perioperation that include temporary ballon occlusion of the iliac ateries,and pelvic adhesion;implantation depth of the placenta included accreta;increta or percreta.Compared the operation time,intraoperative blood loss,intraoperative blood transfusion amount,length hospital stays after surgery and the situation about newborn.Put the hysterectomy as dependent variable the other facors as the independent variable,logistic regression analysis was used to identify the influence factors of hysterectomyResults:The incidence of hysterectomy was 38.0%in PPP patients with placenta accreta.(1)There were no statistical differences at age,body mass index(BMI),level of education,gravidity history,parity history,and gestational weeks between the two groups(P>0.05).(2)There was no statistical differences at the situation of cesarean section history that include times,placenta previa history,where,when,and the neonatal weight between the two groups(P>0.05).(3)There was no statistical difference between the two groups at the condition about perioperation that include temporary ballon occlusion of the iliac ateries and pelvic adhesion(P>0.05).(4)The research group had 1 placenta accreta,9 placenta increta and 9 placenta percreta;the control group had 16 placenta accreta,15 placenta increta and 0 placenta percreta.The research group whose degree of the placenta implantation was significantly more serious than that of the control group(P<0.05).(5)The patients who had GDM,HDP,ICP were 10(52.6%)in research group,there three 3(9.6%)in control group.Compared the 2 groups,the incidence of GDM,HDP,ICP in the research group was significantly higher than that of the control group(P<0.05).(6)The intraoperative blood loss,intraoperative blood transfusion amount and the length hospital after surgery of the research group were significantly more than that of control group(P<0.05).(7)The neonatal birth weight,Apgar score,newborn transfer rates were no statistical difference between the 2 groups(P>0.05).(8)Logistic regression analyize the influence factors of hysterectomy were the degree of placenta accreta(Odds ratio,OR=32.706),GDM,HDP and ICP(OR=17.004).Conclusion:The degree of placenta implantation was the most important factor of hysterectomy in PPP.GDM,HDP and ICP increase the possibility of hysterectomy in PPP.