The Adverse Outcomes Of 96 Cases Of Pernicious Placenta Previa For Puerperas And Newborns

Purpose: To investigate the adverse outcomes of pernicious placenta previa pregnancies and to discuss newborns outcomes.Methods: This was a retrospective study between January 2012 and December 2016 in Shengjing Hospital Affiliated to China Medical University.The study group consisted of96 patients with pernicious placenta previa.The control groups included a central placenta previa group(no history of cesarean section,placenta attached to the anterior wall of uterus),scarred uterus group(cesarean section history,placenta attached to the anterior wall of uterus)and blank control group(no cesarean section history and no placenta previa in this pregnancy,placenta attached to the anterior wall of uterus,with other surgical indications).Results:First,there were significant differencesintraoperative bleeding volume,postpartum bleeding ratio,uterine artery ligation or internal iliac artery ligation ratio,bladder repair ratio and the proportion of intrauterine gauze or balloon filling during operation between study group and control groups(P < 0.05).Second,the interaction between the previous cesarean section and central placenta previa in this pregnancy on intraoperative bleeding volume was statistically significant(F=507.074,p=0.000).Third,placenta increta was the risk factor of hysterectomy,DIC and hemorrhagic shock.Intrauterine gauze or balloon filling during operation was a protective factor against the hemorrhagic shock and DIC.Infrarenal abdominal aorta balloon catheter was a protective factor against hysterectomy and DIC.Forth,the more pregnancies,the higher the risk of hysterectomy.The higher the number of induced abortions and DIC,the higher the risk of hemorrhagic shock.Fifth,compared with scarred uterus group,preterm infants in observation group had lower birth weight and higher proportion of hospitalization after birth,but there was no difference in the number of gestational days and the proportion of neonatal asphyxia.Sixth,the hospitalization rate and neonatal asphyxia rate of premature infants in the group of pernicious placenta previa with placenta increta were higher than those in the group of pernicious placenta previa without placenta increta.Conclusions:Pernicious placenta previa patients,experienced massive intraoperative hemorrhage.Placenta increta was the risk factor of hysterectomy,DIC and hemorrhagicshock,,and had higher risk of premature birth and premature neonatal asphyxia.Intrauterine gauze or balloon filling during operation and Infrarenal abdominal aorta balloon catheter had protective effect on hysterectomy,DIC or hemorrhagic shock.