The Analyzing Of The Effects Of The Perinatal Outcome After Different Diagnostic Timing Of Placenta Accreta And Its Types

Objectives:To explore the effects of maternal and fetal outcomes after different diagnostic timing of placenta accreta and its types.Methods:We retrospectively collected the clinical information of 1178 pregnant women with placenta accrete in Fujian Maternity and Children Health Hospital from January 2012 to January 2017.According to the different diagnostic timing of placenta accrete,they can be divided into groups of prenatal diagnosis and postpartum diagnosis;and according to the types of placenta accrete,they can be divided into groups of accrete group,increte group and percrete group.Analyzing the differences between groups during delivery time,delivery way and the incidence of postpartum hemorrhage,blood transfusion,DIC,secondary laparotomy,hysterectomy,organic damage,infection,neonate birth weight,fetal distress,neonatal asphyxia,small for gestational age and so on.Results:1.The prenatal diagnostic rate of placenta accreta went up year by year In recent five years,especially placenta increta and placenta percreta.2.The diagnostic timing of different types of placenta accrete had obvious differences,98.43% placenta accrete diagnose during vaginal delivery or intraoperative,and 58.33%placenta percreta can be in prenatal diagnosis.3.Age,BMI,admission BMI in the different diagnostic time had no statistical significance,while gravidity,parity and times of caesarean section had statistically significant difference.4.Women with antenatal diagnosis more often had placenta previa and history of previous cesarean section.5.The timing of delivery had statistically significant difference between prenatal diagnosis and postpartum diagnosis.Cesarean delivery was usually called in women with antenatal diagnosis.6.Women with antenatal diagnosis had a higher rate in blood loss and blood transfusion.There were no statistically significant difference at rate of,DIC,secondary laparotomy,hysterectomy,organic damage,infection,neonate birth weight,fetal distress neonatal asphyxia,small for gestational age in different groups.But women with prenatal diagnosis can obviously decrease blood loss and blood transfusion by prenatal intervention.7.Comparing rate of blood loss,blood transfusion,infection,DIC,secondary laparotomy,hysterectomy in different types of placenta accreta had statistically significant differences(P<0.05).The deeper of placenta accreta,the higher the incidence of complications.Conclusion:It is important to pay attention for risk factors of the placenta accrete,then improve prenatal diagnostic rate of the placenta accreta and its types which can forecast the severity of illness to improve maternal and fetal outcomes by timely termination of pregnancy.