| Objective:The clinical data of placenta previa were analyzed retrospectively.According to the type and location of placenta previa,we discussed the influence of the time of termination of placenta previa on the outcome of pregnancy,in order to guide the clinical work of obstetrics in the future and to ensure the safety of mother and child.Research content:The collected cases were grouped according to the type and location of placenta previa.The amount of postpartum hemorrhage,the amount of hemoglobin before and after delivery,the amount of hematocrit before and after delivery,blood transfusion rate,hysterectomy rate,Hemabate utilization rate,interventional operation rate,uterine gauze packing rate and postoperative ICU rate after operation were compared between each group at different gestational weeks.The low weight rate of perinatal infants,neonatal transfusion rate,the rate of neonatal asphyxia and the perinatal mortality were compared.Research methods:The data of pregnant women with placenta previa who were hospitalized and delivered in our hospital from January 2016 to December 2017 were analyzed retrospectively and grouped according to the clinical characteristics.Incomplete placenta previa group(? 37 weeks)and > 37 week group(n = 143);Complete placenta previa of anterior wall ? 36 weeks group(n = 36)?I36-37-week group(n = 28)and > 37-week group(n = 32).Complete placenta previa of posterior lateral wall ? 37 weeks group(n = 43)?37-38 weeks group(n = 28)and > 38 weeks group(n = 17);Risk placenta previa group ? 36 weeks(n = 32)and > 36 weeks group(n = 34).After grouping,the contents of the study were compared and analyzed statistically.Results:(1)There was no statistically significant difference in age between the two groups(P < 0.05)in the non-complete placenta previa,and the number of pregnant women ? 37 weeks was higher than that in the >37 week group,and the difference was statistically significant(P < 0.01).Comparison of pregnancy outcomes between the two groups: the amount of postpartum hemorrhage,hemoglobin and hematocrit before and after delivery,the blood transfusion rate and Hemabate utilization rate in ? 37 weeks group were higher than those in > 37 weeks group,the difference was statistically significant(P < 0.05).Comparison of perinatal outcomes between two groups:In ? 37 weeks group,the incidence of Apgar score of 1 minute<7? the rate of low birth weight(< 2500g)? tneonatal transfusion rate were higher than that of > 37 weeks group(P < 0.05)?There was no significant difference in other groups(P > 0.05).(2)There was no significant difference in age,pregnancy and delivery in the three groups of patients with complete placenta previa on anterior wall(P > 0.05).The pregnancy outcome of the three groups: there was significant difference in postpartum bleeding volume(P < 0.05).The postpartum bleeding volume in 36-37 week group was lower than that in > 37 week group(P < 0.05),but there was no significant difference among other groups(P > 0.05).There was significant difference in the Hemabate utilization rate among the three groups(P < 0.05).After correction,it was found that the Hemabate utilization rate in > 37 weeks group was higher than that in ? 36 weeks group,the difference was statistically significant(P' < 0.0167),but there was no significant difference in other groups(P'>0.0167).There was no statistical difference between the three groups in other studies(P < 0.05).The perinatal outcomes of the three groups were as follows: low birth weight rate(< 2500g),and the neonatal transfusion rate was statistically significant(P < 0.05).After correction,the neonatal low weight rate and neonatal transfusion rate in ? 36 weeks group was higher than that in 36 week-37 week group and > 37 week group.The difference was statistically significant(P'< 0.0167),there was no statistical difference between the other groups(P'>0.0167).There was no statistical difference between the three groups in other studies(P > 0.05).(3)There was no significant difference in age,pregnancy and delivery between the three groups in the complete placenta previa of posterior wall and lateral wall(P > 0.05).Comparison of pregnancy outcomes among three groups: there was significant difference in postpartum bleeding volume(P < 0.05).The postpartum bleeding volume in ? 37 weeks group was higher than that in 37 week-38 week group and > 38 week group,the difference was statistically significant(P < 0.05).There was no significant difference in postpartum hemorrhage between 37-38 week group and > 38 week group(P > 0.05).There was significant difference in blood transfusion rate among the three groups(P < 0.05).After correction,the blood transfusion rate of ? 37 weeks group was higher than that of 37 week-38 week group,the difference was statistically significant(P'< 0.0167),and there was no significant difference between other groups(P'> 0.0167).There was no statistical difference in other contents among the three groups(P > 0.05).Comparison of pregnancy outcomes among three groups of perinatal infants:The neonatal low body weight rate(< 2500g)and the neonatal transfusion rate was statistically significant(P < 0.05).After correction,the newborns' low body weight rate and the neonatal transfusion rate in ? 37 weeks group was higher than that in 37 week-38 weeks group and > 38 weeks group,the difference was statistically significant(P'< 0.0167).There was no statistical difference between other groups(P'> 0.0167).There was no statistical difference among the three groups of perinatal infants compared with other studies.(4)There was no significant difference in age,pregnancy and delivery between the two groups of dangerous placenta previa(P > 0.05).Comparison of pregnancy outcome between the two groups: the postpartum hemorrhage and the rate of interventional surgery were lower in ? 36 weeks group than those in > 36 weeks group(P < 0.05),but no significant difference was found in other studies(P > 0.05).Comparison of perinatal outcomes between the two groups: the low birth weight rate(< 2500g)of and he neonatal transfusion rate in ? 36 weeks group was higher than that in > 36 weeks group(P < 0.05),but no significant difference was found in other studies(P > 0.05).Conclusion:(1)To choose the time of termination of pregnancy with placenta previa clinically,we should focus on the type of placenta previa and placenta attachment,placenta previa of different types and locations,need to choose different time to terminate pregnancy,and make full preoperative evaluation and to reduce the incidence of adverse pregnancy.(2)Cesarean section is the main method of termination of pregnancy in placenta previa.It is safe for patients with incomplete placenta previa to terminate pregnancy after 37 weeks,and the outcome of the maternity and newborn is ideal.(3)In the patients with complete placenta previa on the anterior wall,the termination of pregnancy between 36 weeks and 37 weeks was the most ideal outcome,and the perinatal morbidity and mortality were not increased.(4)In the patients with complete placenta previa on the posterior wall and lateral wall,the pregnant outcome of mother and child was ideal after 37 weeks of termination of pregnancy,in order to improve the prognosis of newborns,it is even possible to approach the termination of preterm delivery..(5)The patients with dangerous placenta previa chose to terminate their pregnancy 36 weeks ago,and the maternal pregnancy outcome of the parturient was ideal but in order to reduce neonatal morbidity and improve neonatal prognosis,pregnancy can be terminated closing to 36 weeks.. |
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