Clinical Analysis of Central Placenta Previa_West China Medical Journal

Authors：

 ZHALi ,  LIYan , LIBo , LAIFan , MEIYou-wen

Department of Obstetrics, Chengdu Women and Children's Central Hospital, Chengdu, Sichuan 610091, P. R. China;

Corresponding author：

LIYan, Email: 519011021@qq.com

Keywords：

Central placenta previa; Cesarean delivery; Hemorrhage; Outcomes of mothers and infants

DOI：

10.7507/1002-0179.20150417

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To explore the related factors for the influences and outcomes of mothers and infants, and further provide a basic reference for reducing maternal and prenatal mortality caused by central placenta previa, through the analysis of its clinical characteristics. Methods We retrospectively analyzed the clinical data of 89 patients with central placenta previa treated from January to August 2012. Results There were 89 patients with central placenta previa, and the average age of these patients was (29.6±11.4) years, and the average number of pregnancy among the patients was 3.17. Nine patients had scar uterus; 8 had pernicious placenta previa (9%); 34 had prenatal anemia symptoms; 44 had prenatal vaginal bleeding with the bleeding volume ranged from 2 to 500 mL; 40 were treated before delivery. The average gestational age was 36 weeks ±4.2 days, and 28 of them were readmitted. The intraoperative bleeding in such patients as had placenta located in the anterior wall, placenta adhesion or implantation, history of uterine cavity operation or multipara was more than other patients. The postpartum hemorrhage of patients with the gestational age of 36 weeks or more was more than that of patients with the gestational age shorter than 36 weeks. The incidence of fetal distress in patients with the gestational age of 36 weeks or more is lower and the neonatal 1-minute Apgar score was higher than that in patients with the gestational age shorter than 36 weeks (P<0.05). Conclusion The treatment of central type of placenta previa should be more active to prolong the gestational week. Patients with placenta adhesion or implantation, caesarean, multipara and placenta in the anterior wall are susceptible to intraoperative bleeding during the termination of pregnancy. Termination of pregnancy in these patients with central placenta previa should be carried out by cesarean section when gestation is more than 36 weeks to reduce postpartum hemorrhage and complications.

Citation： ZHALi, LIYan, LIBo, LAIFan, MEIYou-wen. Clinical Analysis of Central Placenta Previa. West China Medical Journal, 2015, 30(8): 1457-1460. doi: 10.7507/1002-0179.20150417 Copy

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12.	吕莉, 黄丽云. 中央型前置胎盘产后出血危险因素分析[J]. 中国妇幼保健, 2010, 25(36):5378-5379.
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14.	聂红, 董晓梅, 王玉霞, 等. 前置胎盘危险因素与妊娠结局的病例对照研究[J]. 广东医学, 2008, 29(6):996-998.
15.	Balayla J, Bondarenko HD. Placenta accreta and the risk of adverse maternal and neonatal outcomes[J]. J Perinat Med, 2013, 41(2):141-149.
16.	顾彧, 李笑天. 前置胎盘患者终止妊娠时间对母儿预后的影响[J]. 中国妇幼保健, 2004, 19(10):41-42.

1. 乐杰. 妇产科学[M]. 7版. 北京:人民卫生出版社, 2008:116-121.
2. Oppenheimer L, Society of obstetricians and gynaecologists of Canada. Diagnosis and management of placenta previa[J]. J Obstet Gynaecol Can, 2007, 29(3):261-273.
3. Kollmann M, Gaulhofer J, Lang U, et al. Placenta praevia:incidence, risk factors and outcome[J]. J Matern Fetal Neonatal Med, 2015, 4:1-4.
4. Palacios-Jaraquemada JM. Caesarean section in cases of placenta praevia and accreta[J]. Best Pract Res Clin Obstet Gynaecol, 2013, 27(2):221-232.
5. Allahdin S, Voigt S, Htwe TT. Management of placenta praevia and accrete[J]. J Obstet Gynaecol, 2011, 31(1):1-6.
6. Ge J, Liao H, Duan L, et al. Uterine packing during cesarean section in the management of intractable hemorrhage in central placenta previa[J]. Arch Gynecol Obstet, 2012, 285(2):285-289.
7. 王亚林. 产后出血102例临床分析[J]. 中国医药科学, 2011, 1(6):103.
8. 李宏霞, 曾洁, 岳蕾. 100例中央型前置胎盘临床分析[J]. 当代医学, 2010, 16(18):103-104.
9. Silver RM, Barbour KD. Placenta accreta spectrum:accreta, increta, and percreta[J]. Obstet Gynecol Clin North Am, 2015, 42(2):381-402.
10. 余丽英, 罗勤, 傅雪芳. 中央型前置胎盘产后出血的预防[J]. 临床和实验医学杂志, 2006, 5(4):335-336.
11. Hasegawa J, Nakamura M, Hamada S, et al. Prediction of hemorrhage in placenta previa[J]. Taiwan J Obstet Gynecol, 2012, 51(1):3-6.
12. 吕莉, 黄丽云. 中央型前置胎盘产后出血危险因素分析[J]. 中国妇幼保健, 2010, 25(36):5378-5379.
13. 张惜阴. 实用妇产科学[M]. 2版. 北京:人民卫生出版社, 2003:213-215.
14. 聂红, 董晓梅, 王玉霞, 等. 前置胎盘危险因素与妊娠结局的病例对照研究[J]. 广东医学, 2008, 29(6):996-998.
15. Balayla J, Bondarenko HD. Placenta accreta and the risk of adverse maternal and neonatal outcomes[J]. J Perinat Med, 2013, 41(2):141-149.
16. 顾彧, 李笑天. 前置胎盘患者终止妊娠时间对母儿预后的影响[J]. 中国妇幼保健, 2004, 19(10):41-42.

West China Medical Journal

Clinical Analysis of Central Placenta Previa

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