Effect of restrictive infusion in fluid management during cesarean section of patients with pernicious placenta previa

XIAO Liyun; WANG Xin; ZHANG Chunhua; LIU Guangying; JIAO Qiqi; ZHANG Lei

doi:10.3969/j.issn.1002-266X.2025.06.020

Abstract：Objective To observe and evaluate the effect of restrictive infusion in fluid management during cesarean section of patients with pernicious placenta previa.Methods Sixty patients with elective surgery for pernicious placenta previa were retrospectively selected as the study objects,and were divided into the observation group and control group based on fluid management methods,with 30 cases in each group.Patients in the control group received routine rapid fluid infusion,and patients in the observation group received restrictive fluid infusion.The total infusion volume,total blood transfusion volume,total bleeding volume and total urine volume during the operation were compared between patients of the two groups.Hemoglobin(Hb),platelets(PLT),hematocrit(HCT),thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)and plasma fibrinogen(FIB)were recorded before anesthesia(T1)and at the end of surgery(T5).The mean arterial pressure(MAP)and heart rate(HR)were recorded at T1,after induction of anes-thesia(T2),at delivery(T3),30 min after delivery(T4),and T5;the incidence of surgical complications(postpartum hemorrhage,hysterectomy,and bladder injury,etc.)in the two groups was recorded.Results The total intraoperative fluid infusion volume,total blood transfusion volume,and total bleeding volume in the observation group were less than those in the control group(all P<0.05).The Hb,PLT,HCT and FIB of both groups at T5 were lower than those at T1,while the TT,PT and APTT of both groups at T5 were higher than those at T1(all P<0.05);the Hb,PLT,HCT and FIB of the observation group at T5 were higher than those of the control group,and TT,PT,and APTT were lower than those of the control group(all P<0.05).The HR at T5 was lower than that at T1,and MAP at T4 and T5 was lower than that at T1 in both groups(both P<0.05);the MAP of the observation group of patients at T5 was higher than that of the control group(P<0.05).The incidence of total complications in the observation group was lower than than in the control group(P<0.05).Conclusion Restrictive infusion therapy for patients with pernicious placenta previa can effectively reduce the amount of infusion,blood transfusion and bleeding during the operation,improve coagulation function and hemodynamic indicators,and reduce the incidence of complications.