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首页> 外文期刊>The journal of maternal-fetal & neonatal medicine >Morbidly adherent placenta previa in current practice: Prediction and maternal morbidity in a series of 23 women who underwent hysterectomy
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Morbidly adherent placenta previa in current practice: Prediction and maternal morbidity in a series of 23 women who underwent hysterectomy

机译：当前实践中病态粘连的前置胎盘：23例行子宫切除术的女性的预测和产妇发病率

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Objective: To assess the prediction and maternal morbidity of morbidly adherent placenta previa (PP) when currently available management options are used. Materials and methods: This is a retrospective study of all women with PP/morbidly adherent placenta previa (MAPP) delivered at our hospital over a period of 9 years. Data were obtained through hospital registry and medical records search Results: A total of 81 PP were identified, 23 (28.4%) of them had MAPP. All MAPP had previous lower segment cesarean section (LSCS). The following are associated with increased odds of MAPP versus PP, LSCS (OR for each additional LSCS was 2.9 (95% confidence interval: 1.8, 4.5, p ≤ 0.005), age ≥35 years (OR 4.3 (95% CI: 1.4, 12.7, p = 0.008). Anterior or central placenta (OR = 11.6; p = 0.028). Women with previous PP were at risk. Fifteen women were diagnosed by ultrasound [sensitivity 0.65 (0.43, 0.83) and PPV 0.79 (0.54, 0.93)]. MAPP was associated with risk of massive transfusion, bladder injury, DIC and admission to intensive care unit (ICU) (p < 0.005, 0.008, 0.036 and 0.008, respectively). One maternal death was reported in the MAPP group. Conclusion: MAPP is associated with high morbidity and mortality. As the diagnosis is often not certain before delivery, we recommend that all PP and previous LSCS are assumed to be morbidly adherent, and should be managed in properly equipped centers.
机译：目的：评估当使用当前可用的管理方法时，病态粘连性前置胎盘（PP）的预测和母亲发病率。材料和方法：这是一项回顾性研究，对所有9年来在我们医院分娩的PP /病态粘附的前置胎盘（MAPP）妇女进行了回顾性研究。通过医院登记和病历搜索获得数据。结果：共鉴定出81个PP，其中23个（28.4％）患有MAPP。所有MAPP均具有先前的下段剖宫产术（LSCS）。以下与MAPP相对于PP，LSCS的几率增加相关（每增加一个LSCS的OR为2.9（95％置信区间：1.8、4.5，p≤0.005），年龄≥35岁（OR 4.3（95％CI：1.4， 12.7，p = 0.008）。前胎盘或中央胎盘（OR = 11.6; p = 0.028）。先前有PP的女性处于危险中。超声诊断有15名女性[敏感性0.65（0.43，0.83）和PPV 0.79（0.54，0.93） ）]。MAPP与大量输血，膀胱损伤，DIC和进入重症监护病房（ICU）的风险有关（分别为p <0.005、0.008、0.036和0.008），据报道，MAPP组中有1名产妇死亡。 ：MAPP与高发病率和高死亡率有关，由于在分娩前通常不能确定诊断，因此我们建议所有PP和以前的LSCS被认为是病态依附的，应在设备齐全的中心进行治疗。

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