The Clinical Characteristic Of Pernicious Placenta Previa And Evaluation Of Application Effect Of Uterine Artery Embolization

Objectives To analyze the clinical characteristics of different types of pernicious placenta previa, explore the clinical effect of uterine artery embolization in placenta increta and percreta.Methods 231 late pregnancy cases had been collected in Tang Shan materal and service centre from January 2010 to December 2014, for the 231 cases that have placenta implantation, according to intraoperative and postoperative pathological diagnosis, the degree of placenta implantation was divided into placenta accrete(134 cases), placenta increta(61 cases), and placenta percreta(36 cases), then compare the clinical characteristics.97 cases of placenta inplantation(61 placenta increta, 36 placenta percreta) patients,according to the treatment, was divided into two groups: ①Predictability interventional therapy group with 55 cases(experimental group), preset a tubes into femora artery preoperation, according to the evoluation of the depth and scope of implantation introperation, to make the uterine artery embolization, and then deal with the placenta, if necessary, removal the uterus. ②Non-predictable interventional treatment group with 42patients(control group): do not place the tube before surgery, first caesarean section to remove the baby, according to degree of placenta implantation to decide to do the conservative treatment, or even to hysterectomhy, then compare the introperative condition and clinical outcomes.Results 1 The general condition included gestational age, location of placenta, type of placenta previa implanted area among placenta accrete、increta and percreta had obvious defference(P<0.05). The blood loss and RBC, plasma, cryoprecipitate transfusion, the incidence of ICU, hysterectomy, PPH, puerperal infection, DIC, hemorrhagic shock,preterm child, neonatal asphyxia among the three groups had significant difference( P<0.05). 2 Comparing the general condition of age, gestational age, gravidity,caesarean sections, area and depth of implantation, the UAE group and CS group have no significant defference(P>0.05). Comparing the blood loss and RBC, plasma,cryoprecipitate transfusion, incidience of of ICU, hysterectomy, PPH, DIC, hemorrhagic shock, UAE group is lower than CS group, and the difference have a statistical significance(P<0.05).Conclusions 1 It is common that the pernicious placenta previa is associated with placenta implantation, the degree of placenta implantation have nothing to do with age,pregnancies, number of cesarean section. The placenta is more often located in the anterior uterine in the patient that the degree of implantation is more depper. The degree of placenta have an effect on the outcome. 2 Predictability interventional and uterine artery embolization can improve the clinical outcomes of pernicious placenta previa.