从麻醉学角度重新审视前置胎盘和增生胎盘的围手术期结局、风险和并发症

Nevin AYDIN, Nevin TÜTEN
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引用次数: 0

摘要

前言:目的:前置胎盘(PP)和胎盘增生谱是胎盘异常的一种形式,它们与围产期的发病率和死亡率相关。本研究的目的是将基线数据、临床特征、围手术期结局、风险和与PP和胎盘增生性相关的并发症并置。& # x0D;材料与方法:本回顾性研究采用300例诊断为PP的患者(I组,n=237)和胎盘增生谱(II组,n=63)的病历资料。收集的每位患者的信息包括基线描述、围产期数据和术中或术后输血需求、术前和术后血清血红蛋白、纤维蛋白原和c反应蛋白水平、重症监护病房住院需求和持续时间、是否使用血液透析和机械通气。& # x0D;结果:II组体重指数明显高于对照组(p=0.002)。两组在基线描述性数据、围生期、围手术期和术后变量方面无统计学差异。& # x0D;结论:本研究结果表明,尽管有充分的规划和优化的管理策略;与PP和胎盘增生谱相关的显著发病率和死亡率的可能性仍然是显著的。早期密切监测和精心准备对产前和产时管理至关重要。进一步的研究是必要的,以确定易感因素以及理想的诊断、治疗和预防方法。
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Perioperative Outcomes, Risks and Complications Associated with Placenta Previa and Placenta Accreta Spectrum Revisited From an Anesthesiology Perspective
Purpose: Placenta previa (PP) and placenta accreta spectrum are forms of abnormal placentation, and they are associated with significant perinatal morbidity and mortality. The objective of the present study was to juxtapose the baseline data, clinical features, perioperative outcomes, risks, and complications associated with PP and placenta accreta spectrum. Materials and Methods: This retrospective study was performed using data extracted from the medical files of a total of 300 patients diagnosed with PP (Group I, n=237) and placenta accreta spectrum (Group II, n=63). The information gathered for every patient consisted of baseline descriptives, perinatal data and need for intraoperative or postoperative blood transfusion, pre- and postoperative serum levels of hemoglobin, fibrinogen and C-reactive protein, need and duration for intensive care unit stay, whether hemodialysis and mechanical ventilation were employed. Results: The body-mass index was remarkably higher in Group II (p=0.002). There was no statistically significant difference between two groups concerning baseline descriptive data and perinatal, perioperative, and postoperative variables. Conclusion: Results of the present study demonstrated that despite adequate planning and optimal management strategies; the likelihood of significant morbidity and mortality associated with PP and placenta accrete spectrum is still remarkable. Early and close monitoring with careful preparation is momentous for antepartum and intrapartum management. Additional research is essential to determine the predisposing factors as well as ideal methods of diagnosis, treatment, and prevention.
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