Analysis Of Pathological Factors Of Induced Labor In Mid-term Pregnancy And Discusstion Of The Method For Induced Labor Of Placenta Previa

Part ? Analysis of the Influence of Pathological Factors for theComplications of Induced Labor in the Mid-term Pregnancy Objective: To analyse the influence of pathological factors for the complications of induced labor in mid-term pregnancy,so as to provide a basis for further exploring a appropriate method of high-risk induced labor with pathological factors.Methods: 1367 cases received induced labor in mid-term pregnancy were retrospectively analyzed in Affiliated Hospital of Zunyi Medical University from June 2009 to December2018.The general data,pathological factors and recent complications of induced labor in mid-term pregnancy were descriptively analyzed among the 1367 cases.Divided these cases into three groups according to whether they had placental residual,infection or PPH during induced labor,and their pathological factors were divided into two groups and analyzed by chi-square test;at last the statistical significant factors in single factor analysis were analyzed by multivariate Logistic regression.Results:1.The top three pathological factors of induced labor in mid-term pregnancy were placenta previa(367,26.85%),still birth(311,22.75%)and scar uterus(245,17.92%).The top three complications of induced labor were placental residuals(508,37.16%),infection(237,17.34%)and PPH(74,5.41%).2.The pathological factors those affect placental residuals statistically were hypertensive disorders of pregnancy(HDP),pregnancy associated with heart disease,scar uterus,incompetence cervical,still birth,placenta previa,placental abruption and placenta implantation(P<0.05);placenta previa(OR=5.371,95%CI 3.971~7.264),placenta implantation(OR=4.019,95%CI 1.832~8.818),scar uterus(OR=3.255,95%CI2.337~4.535)and stillbirth(OR=3.222,95%CI 2.346~4.425)were the risk factors of placental residues.The pathological factors those affect infection statistically werepregnancy associated with heart disease and hyperthyrea,incompetence cervical,placenta previa,still birth,placental abruption,premature rupture of membranes(PPROM)(P<0.05);incompetence cervical(OR=5.043,95%CI 2.747~9.259),PPROM(OR=2.702,95%CI1.784~4.094),still birth(OR=2.544,95%CI 1.761~3.675)and placenta previa(OR=2.422,95%CI 1.693~3.465)were the risk factors of infection.The pathological factors those affect PPH statistically were HDP,scar uterus,placenta previa,placental abruption and placenta implantation(P<0.05);placental abrutption(OR=12.386,95%CI 5.953~25.772),placenta implantation(OR=12.386,95%CI 5.953~25.772),scar uterus(OR=4.008,95%CI2.318~6.931)and placenta previa(OR=3.353,95%CI 1.941~5.792)were the risk factors of PPH.Conclusion:The main complications of induced labor in mid-term pregnancy are placental residues,infection and PPH.The risk factors of placental residues are placenta previa,placenta implantation,scar uterus and still birth;the risk factors of infection are incompetence cervical and placenta previa,PPROM and still birth;the risk factors of PPH are placental abruption,placenta implantation,scar uterus and placenta pre.viaPart ? Discussion of the opportunity of uterine artery embolizationin the Induced labor with placenta previa Objective: To compare the results of using uterine artery embolization(UAE)before ethacridine lactate and use UAE when maternals were in labor or vaginal bleeding after ethacridine lactate,so as to explore the best opportunity of UAE in the induced labor with complete placenta previa.Methods: 73 cases were analyzed retrospectively from the part I which were diagnosed with complete placental previa without active prenatal hemorrhage or placenta accreta,all cases were induced labor with UAE and ethacridine lactate.The patients were divided into two groups according to the different opportunity of using UAE: Group one was served as control group with 39 cases who were treated with UAE before induced labor with ethacridine lactate;Group two was served as observation group with 34 cases who were treated with UAE when maternal were in labor or vaginal bleeding after ethacridine lactate.And the general data,process,results and complications of induced labor between the two groups were analyzed.Results: The general data of the two groups had no significant difference(P>0.05).In the process and outcome,compared with control group,the observation group has advantages of shorter parturient time,higher rate of success,lower rate of hysterectomize and shorter hospitalization(P<0.05).The time of labor process between the two groups didn't exhibited significant difference(P>0.05),and this phenomenon was also found in the complications,such as bleeding volume,infection,placental residue and hysterectomy between the two groups(P>0.05).Conclusion: Induced labor with UAE when when maternal were in labor or vaginal bleeding after ethacridine lactate has the advantages of higher rate of success and shorter hospitalization,and which not increase the risk of vaginal bleeding,infection and placenta residue,and is worthy of promotion and application in qualified hospitals.