A Clinical Analysis Of Pernicious Placenta Previa

Objective: A study aimed to analyze the clinical data and summarize the clinical characteristics of patient diagnosed with pernicious placenta previa(PPP),to improve the understanding and pregnancy outcomes of the disease.Methods: We conducted a retrospective study at the Second Hospital of Hebei Medical University including 243 cases of PPP between January 2015 and December 2017.Depending on the degree of plcenta implantation,all patients was divided into non-implantation,placenta accrate(PA),placenta increta(PI)and placenta increta(PI).The basic condition and outcomes of the patients were observed.Results:1.The incidence of placenta implantation in PPP showed an increasing trend during the study period.2.Multivariate logistic analysis showed that the number of abortion and cesarean section,central placenta previa were the risk factors for PPP with placenta implantation.The OR value of placenta implantation in PPP increased with the number of abortions and cesarean section.3.Spearman correlation analysis showed that the number of cesarean section and central placenta previa were correlated with the degree of placenta implantation(P<0.05).4.The operation time,intraoperative bleeding,blood transfusion volume,hysterectomy and rate of intensive care unit of PP patients were higher than those of non-implantation,PA and PI patients,and the difference was statistically significant(P<0.05).There was no significant difference between non-implantation and PA patients(P>0.05).5.The application of uterine artery ligation in PI and PP can effectively reduce intraoperative bleeding.6.Multivariate logistic analysis showed that the degree of placenta implantation was an independent risk factor of hysterectomy in PPP patient.7.There was no significant difference in neonatal outcomes between non-implantation,PA,PI and PP(P>0.05).There was a statistically significant difference between the prenatal bleeding group and non-prenatal bleeding group(P<0.05).Conclusion:1.Multiple abortions,multiple cesarean section and central placenta previa are the risk factors for PPP with placenta implantation.The number of cesarean section and central placenta previa were correlated with the degree of placenta implantation of PPP.2.The degree of placenta implantation was positively correlated with intraoperative hemorrhage in patients with PPP.Uterine artery ligation was used in patients with PI and PP can effectively reduce intraoperative bleeding.3.The degree of placenta implantation was an independent risk factor of hysterectomy in PPP patient.4.Neonatal birth weight and the rate of transfer to intensive care unit were associated with PPP combined with prenatal bleeding.