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OBJECTIVE: To analyze the risk factors for peripartum hysterectomy.METHODS: Retrospectively analyze the clinical data of 36 cases of peripartum hysterectomy in Shijiazhuang Obstetrics and Gynecology Hospital from January2012 to December 2018. The impact factors for peripartum hysterectomy were divided into clinical characteristics and obstetric treatment capacity. The annual rates of peripartum hysterectomy were compared and the risk factors for peripartum hysterectomy were analyzed by multi-factor Logistic regression analysisRESULTS: The indications of 36 cases of peripartum hysterectomy were intractable postpartum hemorrhage. The causes of hysterectomy included placenta implantation,amniotic fluid embolism,uterine atony and secondary infection. The annual rate of peripartum hysterectomy decreased gradually due to the promotion of obstetric treatment capacity. The peripartum hysterectomy rate in 2018 decreased significantly（P<0.001,P<0.001,P=0.004,P=0.009）compared with that of 2012,2013,2014 and 2015. Multifactor Logistic regression analysis showed that cesearen-section scar was a risk factor for peripartum hysterectomy（OR=1.403,P=0.018）.CONCLUSION: The severity of disease results in peripartum hysterectomy. The reduction of the peripartum hysterectomy rate lies in the promotion of obstetric treatment capacity,including improving maternal health care,reducing obstetric complications and improving the timely and effective treatment of patients with postpartum hemorrhage.
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Objective To explore the influential factors of dangerous placenta previa pathogenesis,and to analyze their peri natal period outcomes.Methods The clinical data in 143 pregnant women and parturients of dangerous placenta previa(research group) and 286 pregnant women and parturients of non-dangerous placenta previa(control group) in our hospital from January 2011 to December 2015 were retrospectively analyzed.Results The average age of the research group was higher than that of the control group (t =2.92,P =0.004);the previous pregnancy frequency,previous parity,previous abortion frequency,previous cesarean delivery frequency and incidence of placenta previa in the research group were higher than those in the control group(P＜0.01);the incidence of placenta previa in the research group was higher than that in the control group(x2 =7.60,P=0.006);the prenatal gestational weeks of the research group were lower than those of the control group(t=-12.33,P＜0.01).The multi-factor analysis showed that the age,previous abortion frequency and previous cesarean delivery frequency were the influence factors of placenta previa occurrence.Among them,the previous cesarean delivery frequency was the main risk factor.The occurrence rates of antepartum hemorrhage,postpartum hemorrhage,uterine removal and premature infants in the research group were higher than those in the control group(P＜0.01);The intraoperative blood loss of the research group was higher than that of the control group(P＜0.05);the neonatal birth weight and the 1 min Apgar score of the research group were lower than those in the control group(P＜0.05).Conclusion The age,previous abortion frequency and previous cesarean section frequency are related to the occurrence of dangerous placenta previa.
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Objective To explore the application of temporary balloon occlusion in multidisciplinary management of cesarean sec-tion for patients with pernicious placenta previa/accreta.Methods 42 patients with a diagnosis of placenta previa /accrete accepted the temporary aortic balloon occlusion in cesarean section in DSA hybrid operation room were retrospectively studied.Before cesare-an section,intravascular balloon catheter was placed in abdominal aortic.After delivery,the midpoint of filling state balloon was placed at the midpoint of the two renal arteries openings before placental dissection.The amount of blood loss and blood transfusion, operation time,the infants'radiation doses and postoperative complications were determined.Results All patients were successfully fulfilled cesarean section and conserved uteri.The amount of blood loss,blood transfusion,operation time,occlusion time and the infants’radiation doses were (586±355)mL,(422±283)mL,(75.5±1 1.9)min,(22.4±7.2)min and (4.2±2.9)mGy,respec-tively.During follow-up,complications were not found during operation and after operation.Conclusion In women with pernicious placenta previa/accreta,temporary aortic balloon occlusion can effectively control postpartum hemorrhage and reduce the risk of un-desirable hysterectomy.