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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Placenta Accreta Spectrum Disorders, a Formidable Challenge of Contemporary Obstetrics: A Case Series and Brief Review
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Placenta Accreta Spectrum Disorders, a Formidable Challenge of Contemporary Obstetrics: A Case Series and Brief Review

机译：胎盘AccreTa谱紊乱，这是当代产科的强大挑战：案例系列和简要审查

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The prevalence of Placenta Accretea Spectrum disorders (PAS) is rising as a result of increasing caesarean section rates. PAS is considered high risk because of severe maternal morbidity and mortality associated with it. A peripartum hysterectomy is required leading to loss of future fertility. The knowledge and awareness of clinical risk factors, associated with possibility of PAS, is essential for antenatal diagnosis and optimum planning to reduce maternal morbidity. The purpose of present case series was to evaluate the risk factors, the circumstances and modality of diagnosis, clinical course, mode of management, and clinical outcome in six cases of PAS identified at our tertiary care centre, over a period of 18 months from February 2019 to August 2020. All the patients had histological confirmation of PAS. The most common risk factors observed were previous caesarean in five (83.33%) cases, concomitant placenta previa in five (83.33%), multiparity in five (83.33%), and increased maternal age in four (66.66.%) cases. Ultrasound imaging was the imaging modality of choice, but missed diagnosis in two cases. Obstetric haemorrhage was the most common complication observed in five (83.33%) of cases. The primary mode of management was Caesarean delivery followed by hysterectomy. The initiatives such as, Trial Of Labour After Caesarean (TOLAC) and External Cephalic Version (ECV) in Primi breech can help reduce caesarean rates, and thus incidence of PAS. A knowledge of high risk factors and antenatal imaging expertise can help in timely diagnosis of PAS. A good outcome is dependent on early antenatal diagnosis, preparation for delivery and postpartum care. The management should involve a multidisciplinary team.
机译：由于增加剖腹产率，胎盘Accretea谱紊乱（PAS）的患病率升高。由于与它相关的严重母体发病率和死亡率，PAS被认为是高风险的。需要一个脑子宫切除术，导致未来生育能力丧失。临床风险因素的知识和意识，与PAS的可能性相关，对产前诊断和最佳规划以降低产妇发病率至关重要。目前案例系列的目的是评估危险因素，诊断，临床课程，管理模式，六种PAS患者的临床结果，在2月18个月的18个月内2019年至8月2020年。所有患者都有PAS的组织学确认。观察到最常见的危险因素是先前的五个（83.33％）病例，伴随着五（83.33％），五一的胎盘，五分之一（83.33％），并增加了孕产妇年龄（66.66％）病例。超声成像是首选的成像模型，但在两种情况下错过了诊断。产科出血是五分之一（83.33％）的案件中最常见的并发症。主要管理模式是剖腹产术，然后是子宫切除术。诸如Primi臀位（Tolac）和外部头颅（ECV）后劳动力试验的举措可以有助于降低剖腹产，从而提高PAS的发病率。高风险因素和产前成像专业知识可以帮助及时诊断PAS。良好的结果依赖于早期的产前诊断，制备递送和产后护理。管理层应涉及多学科团队。

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