Placenta previa Prevention

Prognosis:

1. Pregnant

(1) anemia: placenta previa major threat to the mother are vaginal bleeding, a small amount of vaginal bleeding in pregnant women is not against, but so many vaginal bleeding occurred in patients with severe anemia and even hemorrhagic shock, so that patients are extremely dangerous state, such as the rescue can not timely death. Surgery because of bleeding and other complications also increased the risk of Crane et al (2000) reported that at 8 years 93,996 births have 308 cases of placenta previa, and its relative risk of hysterectomy was 33.26 degrees, sepsis was 5.55 , thrombotic phlebitis to 4.85. Therefore, the risk of the mother should take it seriously.

(2) placenta accreta: lower uterine segment uterine decidual development than the body, and fetal membranes in patients with placenta previa development more than those without placenta previa were bad at the end of decidual part of the development of incomplete or non-developmental Nitabuch layer also not developed, so patients with placenta previa placenta accreta placenta happened the possibility of much higher than the normal part of growers. Villous development such as myometrial invasion has probably happened is part of implants or completely implanted in the recent literature relating to placenta previa are a lot of placenta accreta, Fox (1972) Review of the 1945 ~ 1969, one of 622 cases of placenta accreta of 1 / 3 occurred in the placenta previa. Placenta accreta with placenta previa risk of higher than normal placenta previa. Ota et al (2000) report Dokkyo University maternity hospital in 9716 cases of placenta accreta in 10 cases, 40% of patients with placenta previa or placenta home were low. Zaki et al (1998) reported 23,070 cases of childbirth, there are 110 cases of placenta previa (0.48%), one of 12 cases (0.05%) placenta previa the placenta has the incidence of adhesions its close relationship with previous cesarean section, no autopsy Palace production history of only 4.1%, there is the history of cesarean section patients were ≥ 3 times as high as 60%. Author thought that, if the history of previous cesarean section, placenta previa the placenta increase the likelihood of adhesions, the more the number of previous cesarean section, the higher the incidence, the danger is that intraoperative bleeding and increase the likelihood of hysterectomy. Worse still, placenta previa, placenta accreta violations of the bladder (Pelosi, 2000) violations of broad ligament (Lin, etc., 1995) have been a number of articles and other reports, these circumstances, so that mothers increase the risk of extra patients are advised to take At some preoperative preparation. Suzuki et al (2001) had seven cases of placenta previa health but the merger of 34 ~ 35 weeks pregnant women make autologous blood supply, collection of blood at 15min in 400ml, its parent uterine artery, umbilical artery and fetal middle cerebral artery with color Doppler wave velocity in patients during and after no change in maternal blood at 24h after the fetal middle cerebral artery pulsatility index decreased significantly on fetal middle cerebral artery pulsatility index of the decline has probably prompted the delay of fetal asphyxia.

2. Fetus and newborn

(1) intrauterine hypoxia: placenta previa often repeated bleeding, if bleeding little impact on the fetus. However, if sudden massive bleeding mother happened hemorrhagic shock, uterine blood supply is also a significant decrease in the fetus in utero may have died due to severe hypoxia.

(2) of neonatal respiratory distress syndrome: placenta previa at the positive expectations of therapy prior to the implementation of complete placenta previa due to bleeding termination of pregnancy, so a higher rate of premature birth, neonatal small, prone to neonatal respiratory distress syndrome (RDS), Bckku et al (2000) report of 99 pregnant placenta previa in 30 ~ 35 weeks of pregnancy when their RDS incidence of cesarean section compared with the control group were 29.3% and the 6.9%, there is significant difference, so the death of rate is high, however since the implementation of look forward to therapy, and dexamethasone in the prevention of drugs RDS, the neonatal mortality rate has decreased significantly. Lin et al (2001) also reported 40 cases of placenta previa during pregnancy with the same control group at 33 weeks pregnancy termination of pregnancy, even though some patients with placenta previa also used prior steroids but who happen RDS group 2 for the 21/40 and 10 / 40, the difference is extremely significant, the authors suggest that in addition to placenta previa in itself, there are other risk factors leading to RDS.

Prognosis: placenta previa affect fetal growth and development, particularly evident after 33 weeks, because of repeated bleeding on the one hand, reduce the maternal and fetal blood exchange, so that fetal nutrition supply on the other hand, with the placenta attached to the location of abnormalities and repeated bleeding placenta to the fetus resulting in fibrosis in chronic hypoxia in utero on the status

Placenta previa in patients with prematurity, low birth weight infants the incidence of higher neonatal asphyxia and mortality has also increased.

Lower uterine segment because of low muscle tissue, contractile force bad, here attached to the placenta not easy to turn off stripping sinusoid noodle, high incidence of postpartum hemorrhage; placenta near the cervix inside the noodle stripping mouth, the puerperal infection will also increase opportunities In addition, the pre - placental implantation of the placenta in patients with amniotic fluid embolism incidence is also higher.

Prevention:

Promotion of contraception, do a good job in family planning, prevention of prolific and avoid repeated curettage or intrauterine infection in order to avoid injury or endometrial endometritis. Strengthening prenatal care and education, bleeding during pregnancy, regardless of the number of required amount of bleeding time, in order to achieve early diagnosis, correct treatment .