Analysis Of High Risk Factors And Pregnancy Outcomes Of Placenta Previa With Placenta Implantation

Objective: To analyze the high-risk clinical factors of placenta previa(PP)with placenta implantation and the effect on pregnancy outcome,and it is of reference value for clinical treatment of this disease.Methods: 225 cases of single-birth pregnant women diagnosed as PP with delivery in the obstetrics department of our hospital from January 2012 to July 2019 were selected,of which 148 cases were implanted without placenta in the PP group,and 77 cases with placenta implantation were PP with placenta implantation group.150 cases of singleton pregnant women undiagnosed PP and placenta implantation during hospitalization and delivery during the same period were used as the control group,and related clinical data were collected and analyzed.Results: 1.Univariate analysis showed that the three groups were statistically different in advanced age,cesarean section delivery history,pregnancy times,abortion times,delivery times,and uterine cavity operation history(all P values<0.05);Comparison between the groups showed that: PP with placenta implantation group and PP group of elderly pregnant women,have cesarean delivery history,pregnancy times ≥2 times,abortion times ≥2 times,delivery times ≥2 times and uterine cavity operation history were higher than those of the control group(all P values <0.05);The proportion of complete PP,elderly pregnant women,cesarean delivery history,cesarean section times ≥2 times,pregnancy times ≥2 times,abortion times ≥2 times and uterine cavity operation history in PP with placenta implantation group was higher than that in PP group(P<0.05),but there was no significant difference in delivery times between the two groups(P>0.05).2.The results of multivariate analysis showed that complete PP,advanced age,cesarean delivery history,and abortion times ≥2 times were independent risk factorsfor PP with placenta implantation(all P values <0.05).3.The median length of hospitalization in PP with placenta implantation group was 8(6 to 11)days longer than that in PP group 7(5 to 9)days,and the median amount of intraoperative bleeding was 1000(600 to 2400)ml more than that in PP group 300(150 to 400)ml.The hysterectomy rate,blood transfusion rate,puerperal infection rate,and ICU conversion rate were higher in PP with placenta implantation group than in PP group,and the above differences were statistically significant(all P values <0.05);There was no significant difference between the two groups in terms of this mode of delivery and antepartum hemorrhage(all P values >0.05).4.The median birth weight of 2600(2100 to 3105)g in PP with placenta implantation group was lower than that of 3000(2570 to 3250)g in PP group,and the Apgar score in one minute was lower than that of the PP group.The preterm birth rate,low birth weight rate,neonatal asphyxia rate,and NICU conversion rate were higher in PP with placenta implantation group than in PP group,and the above differences were statistically significant(all P values <0.05).Conclusions: 1.PP with placenta implantation is closely related to PP type,advanced age,cesarean delivery history,and multiple abortions.Complete PP is an independent risk factor for PP with placenta implantation.During pregnancy,the supervision of pregnant women with high-risk factors should be strengthened.Meanwhile,we should strictly grasp the indications of cesarean section and reduce the cesarean section rate.2.PP with placenta implantation can lead to severe bleeding,hysterectomy,premature delivery and other complications.Improving the rate of prenatal diagnosis,adequate preoperative preparation and the combination of various hemostasis methods are conducive to reduce the occurrence of adverse outcomes.