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| Influence of bilateral internal iliac artery catheterization combined with cesarean section for treating patients with dangerous placenta previa and placenta implantation on their stress status, hysterectomy and neonates situations |
| Sichuan Provincial Maternal and Child Health Care Hospital, Sichuan Province, 610000 |
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Abstract To investigate the influence of bilateral internal iliac artery catheterization combined with cesarean section for treating patients with dangerous placenta previa and placenta implantation on their stress status and hysterectomy rate, and Apgar score of neonates.Methods: The clinical data of 103 pregnant women with dangerous placenta previa and placenta implantation from June 2018 to December 2019 were collected retrospectively.These women were divided into observation group(57 Cases) and the control group(46 cases) according to different treatment methods.The women in the control group were given conventional hemostasis measures combined with cesarean section treatment, and the women in the observation group were given bilateral internal iliac artery catheterization combined with cesarean section treatment.The intraoperative stress response level, surgical status, and the complications and hysterectomy rates of the women, and Apgar scores of the newborns were compared between the two groups.Results: The operative time, intraoperative blood loss, intraoperative blood transfusion, 24h postoperative blood loss of the women in the control group were 158.75± 23.56min, 2870.24± 366.28ml, 14.03± 5.34U, and 1106.73±320.34ml, which were significant higher than those(130.65±17.53min, 1776.34±210.24ml, 6.33±2.78U, and 908.34±135.25ml) of the women in the observation group.The HR(106.34±12.45 times/min), MAP(93.45±7.89 mmHG), serum cortisol(Cor) level(88.43±7.19 pg/ml), adrenocorticotrophic hormone(ACTH) level(32.17±6.78 ng/L), epinephrine(E) level(195.38±20.46ng/ml) of the women in the control group were significant higher than those(84.56±5.43times/min, 79.28±6.23 mmHG, 36.75±5.22 pg/ml, 13.56±3.21 ng/L, and 67.81±10.22 ng/ml) of the women in the observation group.The hysterectomy rate(19.6%, 9 cases), and postoperative complication rate(32.6%, 15 cases) of the women in the control group were significant higher than those(5.3）%, 3 cases, and 10.5%, 6 cases) of the women in the observation group(P>0.05).There were no significant differences in Apgar score of newborns at 1min and 5min after born between the two groups(P>0.05).Conclusion: The treatment of bilateral internal iliac artery catheterization combined with cesarean section for treating patients with dangerous placenta previa combined with placenta implantation has less intraoperative stress response, and has better surgical effectiveness, which can reduce the hysterectomy rate and can improve maternal and infant outcomes.
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