To investigate the diagnosis and the treatment of pernicious placenta previa with cervical accretion to improve the outcome of pregnancy.

Retrospectively analyzed 96 cases of pernicious preplacental placenta with placental accretion treated in Jiangxi Provincial Maternal and Child Health Care Hospital from January 2017 to January 2019. Thirty-two cases with cervical implantation were in the cervical implantation group, 64 cases with lower uterine implantation were in the lower uterine implantation group. The bleeding volume, blood transfusion volume, postoperative hemoglobin level, hemostatic method and postoperative complications were compared between the two groups.

(1) The amount of bleeding in the cervical implantation group was 2000-2975 ml, with an average of 2500 ml, which was significantly higher than that in the lower uterine implantation group (1000-1500 ml, with an average of 1200 ml), (Z=-6.634, P=0.001); The amount of red blood cell suspension, plasma, platelets and cryoprecipitate were also significantly higher than that of the lower uterine implantation group (P<0.05). (2) Fifty-seven cases (89.06%) in the lower uterine segment implantation group were treated with uterine vascular ligation for hemostasis, which was higher than 20 cases (62.5%) in the cervical implantation group ( χ²=9.48, P<0.05). In the cervical implantation group, the rates of cervical circular suture and hysterectomy were 28.13% (9/32) and 34.38% (11/32), respectively, which were higher than those in the lower uterine implantation group, 9.38% (6/64) and 1.56% (1/64), χ²=5.69 and 18.11, P<0.05. (3) The incidence of hemorrhagic shock and bladder injury were 56.25% (18/32) and 15.63% (5/32) in cervical implantation group, respectively, which were higher than that of 14.06% (9/64) and 1.56% (1/64) in the lower uterine implantation group (P<0.05).

The condition of the patients with pernicious placenta previa complicated with cervical implantation is more dangerous. It is important to accurately evaluate the severity of the pregnant women with placenta previa before the operation, choose appropriate hemostatic measures to control hemorrhage in operation and minimize hysterectomy based on the safety of pregnant women.