The effect of the timing of terminating pregnancy with pernicious placenta previa after 34 weeks on the safety of surgery and the outcome with mother and child / 中国医师进修杂志

ABSTRACT

Objective:To explore the effect of different pregnancy termination timings on the delivery safety of maternal women with pernicious placenta previa after 34 weeks.Methods:A total of 84 patients with pernicious placenta previa in Laoshan Campus of the Affiliated Hospital of Qingdao University from March 2018 to March 2019 were selected. The time of admission for delivery was more than 34 weeks. Forty women who pregnant from 34 weeks to 36 weeks of pregnancy was in the study group, 44 women who pregnant over 36 weeks was in the control group, and the pregnancy outcomes of the maternal fetuses of the two groups were compared.Results:The postpartum hemorrhage and the incidence of interventional surgery in the study group were less than those in the control group (754.58 ± 20.35) ml vs. (1 449.26 ± 512.32) ml, 17.5%(7/40) vs. 52.27%(23/44), the differences were statistically significant ( P<0.05). The changes in hematocrit after delivery and before delivery, the amount of hemoglobin after delivery and before delivery, the rate of uterine gauze packing, the rate of Xinmupei, the rate of hysterectomy, the incidence of blood transfusion, the rate of postoperative ICU transfer between two groups hand no significant differences ( P>0.05). The incidence of neonatal birth weight less than 2 500 g and the proportion of transfer to neonatology in the study group were higher than those in the control group 75.0%(30/40) vs. 11.36%(5/44), 80.0%(32/40) vs. 11.36%(5/44), the differences were statistically significant ( P<0.05). There was no significant differences in Apgar scores and mortality rate of newborns after birth between the two groups ( P>0.05). Conclusions:When the pernicious placenta previa is delivered after 34 weeks, the termination of pregnancy before 36 weeks of gestation is more secure for maternal and fetal health. If the fetal development rate is slow, it is necessary to appropriately extend the delivery time, but don′t exceed 36 weeks.