The Clinical Analysis Of 193 Cases Of Placenta Accreta/increta/percreta

Objective To explore the risk factors of placenta accreta/increta/percreta and to kown the efficacy of the balloon occlusion of the abdominal aorta and pelvic vessel during caesarean for the treatment of patients with placenta increta and percreta.Methods We were selected 193 cases of placenta accreta/increta/percreta as the case group in the First Affiliated Hospital of Guangxi Medical University between August 2014 and August 2016,according to the proportion of 1:2 from the same period in hospital childbirth puerpera randomly selected 386 cases as the control group.Related information about the material's and neonate's were collected to explore the risk factors of placenta abnormal implantation.In order to investigate the treatment of the patients who were diagnosed with placena increta or percreta,we were compared patients who underwent the balloon occlusion of abdominal aorta and pelvic vessel followed by caesarean section(21cases)with patients who were just underwent caesarean without endovascular intervention(23 cases)in the blood loss volume in the caesarean,blood transfusion amount,uterus resection and so on.Result 1.The risk factors of the placenta implantation are the advanced age,grandmultiparity(more than three times),previous curettage(more thantwice),previous labour,previous caesarean delivery,placenta praevia,vaginal bleeding in the first timester,in-vitro fertilization(IVF)pregnancy and hypertensive disorders.Moreover,placenta praevia(P=0.00,OR=10.57,95%CI4.38-25.52),IVF pregnancy(P=0.03,OR=1.98,95%CI 1.08-3.63)and vaginal bleeding in the first trimester(P=0.00,OR=4.38,95%CI 2.80-6.84)were the independent risk factors of placenta implantation.2.There were statistically significant differences in the blood loss volume in caesarean,blood transfusion volume,the incidence of perinatal hysterectomy rate,subsequent disseminated intravascular coagulation(DIC)and the admission to intensive care units(ICU)between two groups(P < 0.05);the apgar scores of the neonates were no significant differences(P>0.05)?Conclusion 1.The independent risk of the placenta accreta/increta/percreta are IVF pregnancy,early pregnancy vaginal bleeding and placenta praevia.2.The balloon occlusion of abdominal aorta and pelvic vessel before the cesarean section can effectively decrease the intraoperative blood loss,blood transfusion and the perinatal hysterectomy rate,when patients were diagnosed with placena increta or percreta.3.The technology of the balloon occlusion of abdominal aorta and pelvic vessel had no obvious bad effect of newborn,but we need to do furher tracking to know the long-term effects.