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| Timing selection of placental separation with placenta accreta during cesarean section and the pregnancy outcomes |
| Zaozhuang Maternal and Child Health Care Hospital, Shandong Province, 277110 |
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Abstract Objective: To analyze the timing selection of placental separation of women with placenta accreta during cesarean section, and to analyze the pregnancy outcomes of women. Methods: The clinical data of 152 women with placenta accreta who underwent cesarean section from May 2017 to May 2018 were analyzed retrospectively. According to the timing of manual placenta separation, these women were divided in group A and group B. 80 women in group A had accepted placenta separation immediately after placenta accrete were found, and 72 women in group B had accepted placenta separation till uterine contraction. The changes of hemoglobin (Hb) and hematocrit (HCT) levels of women in the two groups before and after cesarean section were observed. The intraoperative bleeding amount, rate of blood transfusion, rate of B-lynch suture, and rate of special uterine contractions drugs used, rate of postoperative complications, and pregnancy outcomes of women in both groups were recorded. Results: 2 days after cesarean section, the levels of Hb and HCT of women in the two groups had decreased signifficantly (P<0.05), but those had no significant differences between the two groups (P>0.05). The intraoperative bleeding amount, the rates of B-lynch suture and special uterine contractions drugs used of women in group A were 536.4±98.6ml, 8.8%, and 21.3%, respectively, which were signifficant higher than those (346.3±55.7ml, 1.4%, and 2.8%, respectively) of women in group B (P<0.05), but there were no significant different in the number of women with blood transfusion, pregnancy outcomes, and the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Compared with immediate manual placental separation of women with placenta accreta during cesarean section, removal of placenta after uterine contraction can reduce intraoperative blood loss and the special uterine contractions using, and can reduce the probability of uterine B-lynch suture.
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