| Objective: To further explore the different types of placenta previa andpregnancy outcome,expectanting treatment of placenta previa and thecountermeasures of hemorrhage during operation were research, expecting to providea reference for clinical treatment.Method: In our hospital obstetric delivery of131pregnant women with placentaprevia and129cases data exclude the pathological pregnancy normal maternal wereretrospectively analyzed. According to the last prenatal ultrasound results，thepatients were divided into complete placenta previa group (complete PPgroup),incomplete placenta previa group (incomplete PP group), marginal placentaprevia group (edge of the PP group) and low-lying placenta group. In addition, willbe divided into pernicious placenta previa and placenta previa non-dangerous. Theincidence of placenta previa, expectant treatment, hemorrhage during operation andmaternal and perinatal outcome were analyzed.Result:(1) With abortion, cesarean section, assisted reproductive technologyapplications increase, the incidence of placenta previa upward trend from2009to2012,but four years the incidence of placenta previa P=0.490, not statisticallysignificant.(2) The total maternal pregnancy outcomes and perineonate outcomeswere compared among study group and the control group,P=0.000,P=0.008,thedifference was statistically significant. Which, in addition to neonatal mortality wasnot statistically significant, the rest were statistically significant, and P <0.001.(3)The total Maternal pregnancy outcomes and perineonate outcomes were comparedamong the four different types of complete,incomplete, marginal PP and low-lyingplacenta, P=0.939, P=0.968, the difference was not statistically significant.Forpregnant women,incidence of postpartum hemorrhage was highest,the average ratewas34.35%, the difference was statistically significant among4groups,P=0.039;For perinatal infants, incidence of preterm infant was highest,the average rate was57.25%, the difference was not statistically significant among four groups.Fortermination of pregnancy by cesarean section rate was94.66%,the difference wasstatistically significant,among the four groups, P <0.05,For complete placenta previa,cesarean section rate was100%, compare with marginal placenta previa,P=0.000, there was significant difference.(4) The total maternal pregnancy outcomesand perineonate outcomes were compared among the four different types ofpernicious placenta previa and placenta previa non-dangerous,P=0.000,P=0.221,was statistically significant in terms of pregnancy outcome in pregnantwomen.Pregnant women in the postpartum hemorrhage, placenta accreta, thehysterectomy was compared,P=0.000,the difference was statisticallysignificant.(5)For research group,pregnancy outcomes compare emergency surgerywith and elective surgery, x~2=8.056, P=0.234,was not statistically significant. Inpostpartum hemorrhage and1-minute Apgar score≤7points of comparison betweengroups were statistically significant,P=0.018,P=0.002,the rest groups were notstatistically significant.(6) The total postpartum hemorrhage were compared amongthe four different types of complete,incomplete,marginal PP and low-lying placenta,x~2=13.863,P=0.031, the difference was statistically significant. The amount ofbleeding＜500ml and500~1500ml two groups were compared between eachgroups, P=0.033,P=0.030,were statistically significant.For pernicious and non-dangerous type of placenta previa, x~2=27.675,P=0.000, It was statisticallysignificant. The amount of bleeding＜500ml and＞1500ml two groups werecompared between each groups, P=0.000, were significant differences, Comparedwith two types,the proportions of postpartum hemorrhage,pernicious placenta previawas significantly higher than the non-dangerous type of placenta previa.(7)The fourdifferent types of complete, incomplete, marginal PP and low-lying placenta arediagnosed by ultrasound,Ultrasonic consistent with clinical rate of94.67%,totalcompliance rate of91.60%.Conclusion:(1)In recent years, with the abortion, cesarean section rate isrising,the average incidence of placenta previa is gradually increasing.(2) The therapyprocess should follow the principle of individual. On the premise of to ensure thesafety of pregnant women try to prolong the gestational age. Cesarean section is amajor means to deal with placenta previa, emergency termination of pregnancytermination of pregnancy than fully prepared to take the initiative to have a negativeimpact on pregnancy outcomes, especially in postpartum hemorrhage of pregnantwomen and neonatal asphyxia.(3)Placenta previa is a serious complication of late pregnancy. In addition to the in neonatal mortality, In postpartum hemorrhage,hysterectomy,preterm, placenta accreta, etc, the incidence of placenta previa werehigher than normal pregnant women.(4) In strict accordance with neonatal asphyxiadiagnosis and standard recommendations for the diagnosis and classification ofdegree, correct and effective recovery of the newborn, reduce the rate of pretermbirth,neonatal asphyxia and mortality.(5) such as postpartum hemorrhage, placentaaccreta,hysterectomy,The maternal complications of low placenta are not less thanother types of placenta previa, should attach great importance to obstetrician.(6)Inpostpartum hemorrhage, placenta accreta, hysterectomy,the incidence of thepernicious placenta previa was significantly higher than non-dangerous, so thediagnosis and treatment has the particularity.(7) Ultrasonography is the main methodof prenatal diagnosis of placenta previa. It provide an objective basis for placentaprevia prenatal diagnosis and treatment.(8) For placenta previa occurs onprevention and control,while strengthening the check-ups during pregnancy,timelydetection of risk factors,and to take effective interventions for patients with placentaprevia, fundamentally reducing maternal prevalence and mortality and improveperinatal outcomes. |
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