Clinical Analysis Of52Complete Placenta Previa

Objective: To investigate the clinical treatment of complete placentaprevia and effects on pregnancy outcome.Methods: Select52cases of complete placenta previa as the objectof study which born in our hospital between2008to2012, analyze theclinical data retrospectively. According to the characteristics of cases,separate them into several groups, discuss the influence of the firstbleeding gestational week, delivery gestational week, placenta locationand intraoperative treatment on pregnancy outcome. Particularly, discussthe influence of the uterine incision (the placental edge incision vs thetransverse incision of lower uterine segment) and placenta accrete on theblood loss during the operation.Results:1. The incidence of complete placenta previa in our hospitalwas1.34%.2.The delivery gestational week，operation time，the locationof placenta，uterine incision selection，the haemostatic methods and theplacenta accrete all had influence on the blood loss during the operation.They were statistically significant (P<0.05). And the blood loss presentedpositive correlation with the delivery gestational week（P<0.05，r=0.471）,with the increase of gestational week, the blood loss was alsoincreasing.3.Perinatal hysterectomy rate was associated with theoperation time, hemostatic methods and the placenta accrete, they hadsignificant difference (P<0.05). Placenta accrete was the main reason.4. Neonatal weight, the one-minute Apgar scores, neonatal anemia ratio andmortality rate was all associated with the first bleeding gestational week（P＜0.05）. In addition, the delivery gestational week also had asignificant effect on the neonatal weight, and they presented positivecorrelation（P<0.05，r=0.697）, with the increase of gestational week,neonatal weight was also increasing.Conclusion: The earlier the first bleeding gestational week was, theclinical expectant treatment time was longer, and the neonatal prognosiswas better. The positive expectation treatment, extending the deliverygestational week appropriately and reducing emergency cesarean sectionrate were conducive to the pregnancy outcome.Selective operation timeshould be in35~37week, individualized selection was crucial. In theaspects of blood loss during the operation, anterior wall placenta wasmore than the posterior significantly, the transverse incision of loweruterine segment was morn than the Placental edge incision. Hemabate andlower B-Lynch suture combined with the oxytocin and local "8" suture，there was a significant haemostatic effect, effectively reduced thePerinatal hysterectomy rate.