Clinical Analysis Of 23 Cases Of Pemicinous Placenta Previa With Placenta Accreta

Objective To explore the high risk factors of the pernicious placenta previa with placenta accreta, to improve the understanding of its clinical features,to prevent the incidence of the disease.Methods 127 cases of pernicious placenta previa were retrospectively collected from 2005 January and 2013 December in fuyang clinical obstetrics of anhui medical university.23 cases which were placenta accrete pernsons were considered as case group, the remaining 104 cases which were non placenta accrete persons were considered as the control group; the two groups which included the general clinical data and the basic delivery situation were compared.Results 1. From 2005 January to 2013 December in our Hospital pernicious placenta previa with placenta accreta occurred in 18.1%. There is no significant difference between the average age of pernicious placenta previa with placenta accreta and non the placenta accreta. 2. There was statistical significant differences between case group and control group in the age(≥35 years),the number of abortion(≥2 times), the number of cesarean section(≥2 times). 3. During 127 cases of pernicious placenta previa, central placenta previa were 41 cases,which included 13 cases of placenta accrete(31%), paritial placenta previa were 59 cases,which included 6 cases of placenta accrete(10%), marginal placenta previa were 7 cases which included 4 cases of placenta accrete(14%), the centralplacenta previa with placenta accrete was significantly more than the part type and marginal type(p < 0.05), the difference was statistically significant. 4. 127 cases of pernicious placenta previa were divided into two groups,according to the main placenta position,pernicious planceta previa placenta was attached in accordance with main body position divided into two groups,the anterior wall group(placenta body in the anterior uterine wall) for 44 cases,which 14 cases of placenta accreta accounted for 31.8%,posterior wall group(placenta body in the lateral uterine wall and posterior uterine wall) for 83 cases,which 9 cases of placenta accreta accounted for 10.8%, the results showed the anterior wall group((placenta body in the anterior uterine wall) significantly more than posterior wall group(p<0.05), the difference was statistically significant. 5. Basic operation situation : the case group incidence of bleeding time,operation time, removal of the uterus and the transfer to icu were more than the control group(P < 0.05), the difference was statistically significant. 6. Neonatal outcome comparison: there is no significant difference between the case group and control group the rate of preterm birth(P=0.838), the rate of neonatal asphyxia(P=0.131).Conclusions The high risk factors of pernicious placenta previa complicated with placenta accreta were repeated abortion, cesarean section, the elder women, the placenta in the anterior uterine wall, the central type of placenta previa.Pernicinous placenta previa with placenta accreta had greater effects on maternal and neonatal outcomes, which should be paid more attention by the obstetrician, be strengthened multidisciplinary contact. Advocate perinatal health care, reduce the rate of cesarean section, reduce the pernicious placenta previa complicated with placenta implantation from the route.