Risk fa ctors of pregnancy termination at second and third trimester in women wi th csarred uterus and placenta previa
10.3785/j.issn.1008-9292.2015.05.02
- VernacularTitle:瘢痕子宫合并前置胎盘孕妇孕中晚期引产的危险因素分析
- Author:
Ji-Shun TIAN
1
;
Fei-Xia PAN
;
Sai-Nan HE
;
Wen-Sheng HU
Author Information
1. 浙江大学医学院附属妇产科医院产科
- Keywords:
Placenta previa;
Cicatrix;
Uterine diseases;
Cesarean section/adverse effects;
Labor,induced;
Arteries;
Uterus;
Pregnant women;
Pregnancy trimester;
Second;
Retrospective studies
- From:
Journal of Zhejiang University. Medical sciences
2015;(3):247-252
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the risk factors of pregnancy termination at second and third trimester in women with scarred uterus and placenta previa .Mtehods:Clinical data of 24 pregnant women of second and third trimester with a scarred uterus and placenta previa ,who requested termination in Women ’s Hospital Zhejiang University School of Medicine from July 2009 to June 2014 , were retrospectively analyzed .The method of mifepristone combined with ethacridine lactate was adopted for all cases . Mifepristone combined with ethacridine lactate and uterine artery embolization were routinely given for patients with complete placenta previa . Cesarean section was performed for patients who failed to delivery or underwent massive vaginal bleeding before delivery. Age, gestational weeks, gravidity and parity, times of previous cesarean section , the interval from previous operation , the position and the type of placenta previa , placenta accretet , the indication and method of termination , postpartum hemorrhage , successful rate of labor induction , placental retention ratio and uterus rupture were documented .Results: The successful rate of labor induction was 83 .3%.The analysis showed that age , gestational weeks , gravidity and parity and times of previous cesarean section were not risk factors for failed labor induction , however the interval time from previous operation was related to induction failure ( P<0.05 ) .Patients with previous cesarean section ≥13 years were more likely to require cesarean section than those <13 years ( P<0 .05 ) .The placenta adhered to the antetheca of the uterus or placenta accrete increased risk to have cesarean section . There were no significant differences in postpartum hemorrhage , the successful rate of labor induction, placental retention ratio and the rate of uterine rupture between patients with uterine artery embolization and those without .Conclusion: The labor induction would be feasible for women with a scarred uterus and placenta previa in second and third-trimester pregnancy.The previous operation ≥13 years, the antetheca placenta or placenta accrete might increase the incidence of labor induction , while the uterine artery embolization would rise the successful rate of labor induction .
