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首页> 外文期刊>Open Journal of Obstetrics and Gynecology >Modified Triple P Approach by Gynecologic Oncologist-Led Team for Placenta Accreta Spectrum Improves the Outcome: Non-Randomized Controlled Trial
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Modified Triple P Approach by Gynecologic Oncologist-Led Team for Placenta Accreta Spectrum Improves the Outcome: Non-Randomized Controlled Trial

机译：妇科肿瘤科医师带领的小组针对胎盘积压频谱改良的Triple P方法可改善结果：非随机对照试验

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Introduction: Placenta Accreta Spectrum (PAS) is associated with significant maternal and fetal morbidity and mortality. The ideal conservative management still does not exist. We aimed to compare the outcome of cesarean section for PAS by a gynecologic oncologist-led team using the modified triple P approach and by a non-gynecologic oncologist-led team. Material and Methods : This is non-randomized controlled trial. Group A had Cesarean Section by gynecologic oncologist. Gynecologic oncologist-led team did all Cesarean Section following a modified triple P approach. The first P is for “Plan” the uterine incision. The second P for “Pelvic” devascularization by internal iliac artery ligation. The third P is for Placenta non-separation with resection of the myometrium. Group B had Cesarean Section by non-gynecologic oncologist-led team. The main outcome measures were the need for hysterectomy, amount of blood loss, and the management-related complications. Results : Group A had significantly less estimated blood loss, and received less n umber of backed RBCs units, and less operative time than group B. The uterus is preserved in all cases of group A and in 50% of cases of group B. The overall maternal morbidity rate was 17.5% in group A and 72.2% in group B. Conclusion: This study provides evidence that the modified triple P approach for PAS by gynecologic oncologist-led team presents lower maternal morbidity in comparison to surgery by non-gynecologic oncologist-led tea m.
机译：简介：胎盘Accreta频谱（PAS）与明显的母婴发病率和死亡率相关。理想的保守管理仍然不存在。我们的目的是比较由妇科肿瘤科医生领导的小组使用改良的Triple P方法和非妇科肿瘤科医生领导的小组剖宫产的PAS的结果。 材料和方法：这是非随机对照试验。 A组由妇科肿瘤科医生进行了剖腹产。妇科肿瘤学家领导的小组在采用改进的三重P方法后进行了所有剖腹产手术。第一个P用于“计划”子宫切口。第二个P用于通过by内动脉结扎进行“盆腔”血运重建。第三个P用于胎盘不分离并切除子宫肌层。 B组由非妇科肿瘤科医生领导的小组进行了剖腹产。主要结局指标是子宫切除术的必要性，失血量以及与管理相关的并发症。 结果：与B组相比，A组的估计失血量明显减少，接受支持的RBC数量减少，手术时间更少。 B组病例。A组的整体孕产妇发病率分别为17.5％和B组的72.2％。结论：本研究提供了由妇科肿瘤科医生领导的小组对PAS进行改良的三联P疗法的证据。与非妇科肿瘤科医生领导的茶相比，产妇的发病率更低。

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