关键词: 凶险性前置胎盘, 前置胎盘, 胎盘, 侵入性, 保留子宫

Abstract: Objective：To investigate the preserving uterus operation mode and improve prognosis with pernicious placenta previa and placenta accreta. Methods：The clinical data of 178 patients with placenta previa and placenta accreta admitted to Henan provincial people′s Hospital, from April 2015 to November 2017 were analyzed retrospectively. According to the situation in the operation, patients underwent caesarean section, cerclage with tourniquet, ligation of ascending branch of uterine artery, cervical lifting suture, partial resection of anterior portion of lower uterine, double incision of lower uterine, stuffing with intrauterine balloon，and temporary aortic balloon of the abdominal aorta. Results：The mean blood loss of all 178 patients was 1 500 (1 421.5, 1 757.7) mL. The mean blood loss of 156 patients had not temporary aortic balloon of the abdominal aorta was 1 600(1 461.3, 1 707.2)mL, the blood loss of 22 patients had temporary aortic balloon of the abdominal aorta was mean 1 800 (1 761.9, 1 912.7) mL, there was no statistical significance (Z=2.13, P=0.98). The incidence of postoperative infection of intrauterine balloon and those without intrauterine balloon was 23.9% (22/92) vs. 18.6% (16/86), there was no statistical significance (χ2=0.75, P=0.39). 1 patient was treated with hysterectomy due to extensive placenta accrete. All patients were restored to health and discharged. Conclusions：A variety of surgical procedures were applied to the treatment of placenta previa and placenta accreta, which reduced the amount of bleeding during operation. Most of the uterus was retained, and achieved good results.

Key words: Pernicious placenta praevia, Placenta previa, Placenta accreta, Conserving uterus