Analysis of the relationship between different types of placental implantation after cesarean section and previous cesarean section / 中国医师进修杂志

ABSTRACT

Objective To analyze the correlation between different types of placental implantation after cesarean section and previous cesarean section.Methods The data of 7 286 pregnant women with second pregnancy after cesarean section from January 2010 to October 2018 were retrospectively analyzed.Among them,842 cases had placental implantation.Five hundred and ninetyseven cases were adhesion type,204 cases were implantation type and 41 cases were penetration type.The relationship between the type of placental implantation in this pregnancy and emergency operation and postpartum hemorrhage during previous cesarean section and the time from this pregnancy was analyzed.Results The total incidence of placental implantation and the incidence of three types of placental implantation in the transfer operation group was higher than that of non-transfer operation group,total27.4％ (419/1528) vs.7.3％ (423/5 758);adhesion type18.0％ (275/1 528) vs.5.6％ (322/5 758);implantation type7.9％ (121/1 528) vs.1.4％ (83/5 758);penetration type1.5％ (23/1 528)vs.0.3％ (18/5 758),and there were significant differences (P＜0.01).The total incidence of placental implantation and the incidence of three types of placental implantation in postpartum hemorrhage group was higher than that in the non-postpartum hemorrhage group,total33.9％ (74/218) vs.10.9％ (768/7 068);adhesion type22.5％ (49/218) vs.7.8％ (548/7 068);implantation type9.6％ (21/218) vs.2.6％ (183/7 068);penetration type1.8％ (4/218) vs.0.5％ (37/7 068),and there were significant differences (P＜0.01).There was no statistical significance between the time of pregnancy and the incidence and total incidence of three types of placental implantation (P＞0.05).Conclusions Placental implantation after cesarean section may be closely related to emergency operation and postpartum hemorrhage during the previous cesarean section.Pregnant women with second pregnancy after cesarean section should strengthen the management of pregnancy.