| Background This study compared the results between selective operation and emergency operation during the same pregnancy cycle.Because,with the increase in the number of weeks of pregnancy,the occurrence of placental accreta and postpartum massive hemorrhage is a common and serious complication during pregnancy,which can lead to severe bleeding,shock,and thus affect the blood circulation of the fetus,Fetal distress,neonatal asphyxia and other complications seriously threaten the safety of pregnant women and perinatal infants.At present,some studies have shown that for patients with severe placenta previa,choosing the right time to terminate pregnancy can improve the risk of placenta preimplantation.Maternal and infant pregnancy outcomes of discoid patients.However,since the related studies are limited to small sample retrospective studies,there is no consensus on when to terminate pregnancy in patients with sexually aggressive placenta previa to obtain the optimal pregnancy outcome.In the face of the increasing incidence of the dangerous placenta previa and its adverse effects on mothers and infants,we not only study the causes of its occurrence,but also reduce its occurrence from the source.It is also very important and urgent to strengthen the management of the pregnancy period of the patients with severe placenta previa and to choose the appropriate time to terminate the pregnancy in order to avoid the occurrence of the bad pregnancy outcome..Objective A retrospective analysis of the medical record data of the patients with the pervasiveness of the placenta was retrospectively analyzed.The operative condition and the outcome of the perinatal period were compared and analyzed,and the optimal time of termination of the pregnancy was selected for the patients with the pervasiveness,and the basis of the clinical intervention was provided..Methods To collect the clinical data of patients diagnosed as dangerous placenta previa during the period from January 2017 to October 2018,who were hospitalized and delivered in our obstetrical department,and whose gestational week was more than 34 weeks after termination of pregnancy,According to the gestational weeks of termination of pregnancy,they were divided into three groups: 35 weeks of gestation ≥ 34 weeks of gestation(group A),36 weeks ≥ 35 weeks of gestation(group B),37 weeks ≥ weeks of gestation ≥ 36 weeks of gestation(group C).According to placenta accretion or not,they were divided into dangerous preplacental placenta with implantation group(group D)and non-invasive placenta previa group(group E),and the amount of intraoperative bleeding,hysterectomy and one minute postnatal Apgar of the patients in the group were counted.Score,neonatal transfer to NICU treatment rate..Results The average intraoperative bleeding volume was 1436.11 ±1522.62 ml in group A,1730.43 ±1348.54 ml in group B and 1821.88 ±1079.64 ml in group C(P>0.05).The average hospitalization days in group A were significantly lower than those in group B(6.75 ±2.03 days),and those in group C were 7.83 ±2.57 days and 8.16 ±2.38 days(P < 0.05).The neonatal asphyxia rate in group A was 5.6%,the average bleeding volume was 1436.11 ±1522.62 ml,the rate of neonatal asphyxia in group B was 21.7%,and the rate of neonatal asphyxia in group C was 28.1%,and there was significant difference among the three groups(P < 0.05).The rate of emergency operation in group A was significantly lower than that in group B(11.1%)and in group C(30.4% and 37.5%)(P < 0.05).The average intraoperative bleeding volume in group D was 2083.7 ±2120.53 ml,which was significantly higher than that in group E(1015.2 ±913.5ml).The hysterectomy rate in group D was 9.5% higher than that in group E(1.4%).The difference was statistically significant(P < 0.05).Conclusion The rate of emergency operation was the lowest,the average number of days of hospital stay was the least,the asphyxia rate of the newborn and the rate of treatment to the NICU after birth were the lowest,and the difference was statistically significant(P <0.05). |
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