A clinical study was made on a series of 91 cases of placenta previa which were managed by cesarean section(include 19 cases of cesarean hysterectomy) for 10 years(Jannuary, 1986~December, 1995).
@ES The results obtained as follows:
@EN The incidence to delivery was 0.61. The majority was concentrated on multiparous women, at the age of 26 to 34, and had history of abortion. The first main presenting symptom was painless vaginal bleeding(70.3%) and about one fifth of the
cases
were
associated with malpresentation.
About three fourth of the cases were diagnosed at the gestational weeks of 28 to 36 and totalis variety was 64.8%.
About two third of cases were operated as emergency and the majority(96.7%) was managed by lower segment transverse incision. 19 cases were managed by cesarean hysterectomy and its indication was uncontrolled uterine bleeding. The average blood
loss was
1,190 cc(400~2,500 cc) at cesarean section and 3,100 cc(1,500~15,000 cc) at cesarean hysterectomy.
Over one half of the cases were delivered at term and about two third of neonates were over 2,500 gm in weight. There were 8 cases. of neonatal death and 5 cases of fetal death. The perinatal mortality rate was 14.3% and its main cause was
prematurity.
The marternal morbidity and complications were 15 cases of postoperative hemorrhage(16.5%), 8 cases of puerperal fever(8.8%), 4 cases of urinary tract infection(4.4%), 3 cases of wound infection(3.3%), 3 cases of bladder injury(3.3%), 3 cases of
disseminated intravascular coagulopathy(3.3%) and 2 cases of pulmonary edema(2.2%). The grave complications occurred in cases of cesarean hysterectomy and one case of maternal death (1.1%) was encountered.
|