Clinical Analysis Of High Risk Factors And Maternal And Infant Outcomes Of Pernicious Placenta Previa With Placenta Accreta

Objective:By analyzing the high risk factors and maternal and infant outcomes of pernicious placenta previa with placenta accreta,this study summarized its clinical characteristics,so as to provide some reference for clinical treatment and ensure the safety of maternal and infants.Methods:This thesis collected 156 patients with pernicious placenta previa who delivered in our hospital from January 2014 to December 2019.According to whether they were complicated with placenta accreta or not,75 patients without placenta accreta were classified as group A,the other 81 patients with placenta accreta were classified as group B.According to the degree of placenta accreta,patients in group B were further divided into placenta accrate group(PA)with 13 patients,placenta increta group(PI)with 38 patients,placenta percreta group(PP)with 30 patients.The clinical data such as whether the patient was over 35 years old,times of pregnancy,delivery,abortion and cesarean section and whether the previous pregnancy was elective cesarean section,and maternal and infant outcomes were retrospectively analyzed.Results:1.There were significant differences in mean age and gestational weeks of delivery between the two groups(P<0.05).2.Elderly age(age≥35),times of labor≥2,times of abortion≥2,times of cesarean section≥2 and central placenta previa in group B were higher than those in group A,and the difference was statistically significant(P<0.05).There were 65 cases(86.67%)with more than two pregnancies in the group A,and 73 cases(90.12%)in group B,there was no significant difference between the two groups(P>0.05).3.Among patients with pernicious placenta previa,the proportion of patients with placenta accreta who had previous elective cesarean section(76.54%)was higher than that without placenta accreta(53.33%),the difference was statistically significant(P<0.05).4.The results of multivariate logistic regression analysis showed that the number of abortion,cesarean section and central placenta previa were correlated with placenta accreta,and the regression coefficients were 1.021,2.247 and 2.175,with statistical significance(P<0.05).5.By stratified the abortion times and cesarean section history according to their times(abortion 0,1,≥2;cesarean section 1,≥2),this thesis analyzed the impact of abortion times and cesarean section history on placenta accreta.The results showed that the OR value increased with the increase of abortion times and cesarean section times.6.The results of Kruskall-Wallis test showed that the operation time,intraoperative blood loss,hysterectomy rate and ICU admission rate of patients with pernicious placenta previa in group PP were significantly higher than those of patients without placenta previa group,group PA and group PI(P<0.05).7.There was significant difference in gestational age among the patients without placenta previa group,group PA,group PI and group PP(P<0.05);There were no significant differences in the average birth weight,Apgar score and the rate of transfer to NICU among the four groups(P>0.05).Conclusions:1.The high risk factors of placenta accreta in pernicious placenta previa patients are elderly age(age≥35),multiple childbirth,multiple abortions,multiple cesarean sections and central placenta previa.2.Elective cesarean section without begining of birth process may increase the risk of placenta accreta in pernicious placenta previa patients.3.The operation time,blood loss and hysterectomy rate of pernicious placenta previa patients were related to the severity of placenta accreta.