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首页> 外文期刊>The journal of maternal-fetal & neonatal medicine >The role of supracervical hysterectomy in reducing blood products requirement in the management of placenta accreta: a case-control study
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The role of supracervical hysterectomy in reducing blood products requirement in the management of placenta accreta: a case-control study

机译：Supracercalical子宫切除术在减少血液产品需求的胎盘治疗中的作用：一种案例对照研究

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Objective:While surgical management is the treatment of choice for abnormally invasive placenta, the role of supracervical hysterectomy in this setting is not well established. We aimed to compare supracervical versus total cesarean hysterectomy as a surgical option for abnormally invasive placenta. Methods:We carried out an 8-year retrospective case-control study. Six cases of a patient treated by total hysterectomy were matched and compared to 30 controls treated by supracervical hysterectomy. Matching of cases with controls was based on coexisting placenta previa, a number of previous cesarean sections, and age, with five controls per case. Cases and controls were comparable in placental invasion topography. We compared the operative approach in all histologically identified cases of abnormally invasive placenta. Results:Overall, 36 women with histologically proven abnormally invasive placenta were identified. Composite blood products morbidity was higher among total hysterectomy patients (p= .02). Freshly frozen plasma utilization was greater among total hysterectomy patients (p= .01). Median operative time (142 +/- 48 versus 136 +/- 58 minutes) and hospitalization time (8.9 +/- 3.1 versus 7.3 +/- 1.5 days) were comparable between those who underwent supracervical versus total hysterectomy (p> .05). No case of maternal or neonatal death was encountered. Conclusion:The favorable maternal and perinatal outcomes observed in our study, suggest that supracervical hysterectomy should be considered as the first-line approach in cases of abnormally invasive placenta managed operatively.
机译：目的：虽然手术管理是治疗异常侵入性胎盘的选择，但对这种环境中的Supracercical子宫切除术的作用并不明确。我们的目标是将Supracerercical与总剖腹产镜切除术进行比较，作为异常侵入性胎盘的手术选择。方法：我们开展了一个8年的回顾性案例控制研究。通过总子宫切除术治疗的6例患者匹配，并将其与Supracteracal子宫切除术治疗的30个对照进行比较。对控制案件的匹配是基于共存胎盘PREVIA，此前一系列剖腹产和年龄，每个案件有五个控制。病例和对照在胎盘入侵地形方面是可比的。我们比较了所有组织学鉴定的异常侵袭性胎盘的病例中的手术方法。结果：总体而言，鉴定了36种组织学证明异常侵入性胎盘的女性。复合血液制品在总子宫切除术患者中发病率较高（P = .02）。在总子宫切除术患者中，新冷冻等离子体利用率更大（P = .01）。中位数手术时间（142 +/- 48与136 +/- 58分钟）和住院时间（8.9 +/- 3.1与7.3 +/- 1.5天）相当于Supractercical与总子宫切除术的人之间相当（p> .05） 。没有遇到母亲或新生病死亡。结论：在我们研究中观察到的有利孕产妇和围产期结果，表明Supracercical子宫切除术应被视为在可操作地管理异常侵袭性胎盘的一线法中。

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