Effect Of Interventional Therapy In Pernicious Placenta Previa Complicated With Placenta Implantation

The pernicious placenta previa(PPP)refers to the placenta of this pregnancy is attached to the uterine incision of last cesarean delivery.In recent years,with the opening of the second-child policy and the increase in cesarean section rate,the incidence of pernicious placenta previa has increased.The pernicious placenta previa is often complicated with placenta implantation,which leads to a significant increase in the risk of blood loss and blood transfusion during cesarean section.Obstetricians often choose hysterectomy to save their lives for pregnant women with intractable postpartum hemorrhage,but the loss of maternal reproductive function will have a great impact on their individuals and families.Under this background,the aim of this research was to study the effect of intra-aortic abdominal aorta balloon occlusion(IAABO)in the treatment of pernicious placenta previa complicated with placenta implantation.ObjectiveThis study collected the clinical data of pregnant women who accepted IAABO during cesarean section in the Third Affiliated Hospital of Zhengzhou University,and collected the clinical data of patients with PPP complicated with placenta implantation who underwent routine cesarean section(without IAABO during surgery)for retrospective analysis.The purpose of this study is to discuss the effectiveness and safety of intra-aortic abdominal aorta balloon occlusion in the cesarean section of patients with pernicious placenta previa complicated with placenta implantation.Materials and MethodsA total of 140 delivery patients with pernicious placenta previa complicated with placenta implantation in the Third Affiliated Hospital of Zhengzhou University during the period from January 2017 to June 2018 was retrospectively analyzed.They were divided into 2 groups.118 patients adopted Intra-aortic abdominal aorta balloon occlusion during cesarean section,which was Group IAABO.In the Group Routine,22 patients underwent the routine cesarean section without IAABO,while other methods are used to stop bleeding according to the situations at surgery.The patient name,age,contact information,gestational weeks,gravidity,parity,number of previous cesarean delivery,the amount of blood loss and blood transfusion during operation,the complication(fever,infection,pain,thrombosis,puerperal infection,etc.),the rate of hysterectomy,rate of bladder injury,hospital stays,neonatal weight,Apgar score of 1min and 5min,the duration of lochia and menstruation recovery were summarized and analyzed.Differences between the two groups were compared and A P value of< 0.05 was considered statistically significant.Result1.Comparison of general information between Group IAABO and Group Routine: There was no significant difference in age,gestational weeks,gravidity,parity,number of previous cesarean delivery between the two groups(P=0.505,P=0.171,P=0.212,P=0.883,P=0.658).2.Comparison of the intra-operative situation between Group IAABO and Group Routine:The amount of blood loss and blood transfusion during operation of patients with IAABO were reduced(P = 0.036,P =0.042);The rate of hysterectomy of Group IAABO was lower than that of Group Routine(P=0.024);there was no significant difference in the rate of bladder injury between the two groups(P=0.580).3.Comparison of postoperative situation between Group IAABO and Group Routine: There was no significant difference in the hospital stays between the two groups(P=0.582).There was no significant difference in the incidence of postoperative complications between the two groups(P=0.575).4.Comparison of situation after hospital discharge between Group IAABO and Group Routine: There was no significant difference in the duration of lochia and menstruation recovery between the two groups(P=0.686,P=0.714).5.Comparison of neonatal conditions between Group IAABO and Group Routine: There was no significant difference in neonatal weight,Apgar 1min score and 5min score between the two groups(P=0.112,P=0.687,P=0.669).ConclusionIn the cesarean section of patients with pernicious placenta previa complicated with placenta implantation,Intra-aortic abdominal aorta balloon occlusion minimize the amount of bleeding during operation,reduce the risk of hysterectomy,and the incidence of related interventional complications is low.