剖宫产切除术在紧急分娩和有计划的胎盘分娩中的胎儿和母体结局。

IF 2 Q2 OBSTETRICS & GYNECOLOGY Obstetrics and Gynecology Science Pub Date : 2024-01-01 Epub Date: 2023-12-04 DOI:10.5468/ogs.23154
Şükran Doğru, Fatih Akkuş, Aslı Altinordu Atci, Ülfet Sena Metin, Mehmet Uyar, Ali Acar
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引用次数: 0

摘要

目的:本研究评价急诊子宫切除术与计划节段性子宫切除术对先天性胎盘(PPC)和前置胎盘(PP)患者的母婴预后。方法:本研究纳入了计划或紧急子宫节段切除术的PP和PPC患者。比较了人口统计学数据、出血性发病率、手术内和术后并发症、住院时间、手术时间、围产儿和新生儿发病率。结果:本研究共纳入141例PPC和PP病例。急诊子宫切除术25例(17.73%),计划节段性子宫切除术116例(82.27%)。两组患者术后血红蛋白变化、手术次数、总输血量、膀胱损伤、住院时间差异无统计学意义(P=0.7、P=0.6、P=0.9、P=0.9、P=0.2)。胎儿体重、5分钟Apgar评分和新生儿重症监护病房入院率在组间无显著差异。出血患者分娩时的胎龄低于主动分娩并接受择期手术的患者(32周[95%可信区间[CI], 26-37周]vs. 35周[95% CI, 34-35周],P=0.037)。结论:采用多学科方法,本研究在三级中心进行,显示产妇和胎儿的发病率和死亡率在急诊和计划的节段性子宫切除术之间没有显著差异。
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Fetal and maternal outcomes of segmental uterine resection in emergency and planned placenta percreta deliveries.

Objective: This study evaluated maternal and fetal outcomes of emergency uterine resection versus planned segmental uterine resection in patients with placenta percreta (PPC) and placenta previa (PP).

Methods: Patients with PP and PPC who underwent planned or emergency segmental uterine resection were included in this study. Demographic data, hemorrhagic morbidities, intra- and postoperative complications, length of hospital stay, surgical duration, and peri- and neonatal morbidities were compared.

Results: A total of 141 PPC and PP cases were included in this study. Twenty-five patients (17.73%) underwent emergency uterine resection, while 116 (82.27%) underwent planned segmental uterine resections. The postoperative hemoglobin changes, operation times, total blood transfusion, bladder injury, and length of hospital stay did not differ significantly between groups (P=0.7, P=0.6, P=0.9, P=0.9, and P=0.2, respectively). Fetal weights, 5-minute Apgar scores, and neonatal intensive care unit admission rates did not differ significantly between groups. The gestational age at delivery of patients presenting with bleeding was lower than that of patients who were admitted in active labor and underwent elective surgery (32 weeks [95% confidence interval [CI], 26-37] vs. 35 weeks [95% CI, 34-35]; P=0.037).

Conclusion: Using a multidisciplinary approach, this study performed at a tertiary center showed that maternal and fetal morbidity and mortality did not differ significantly between emergency versus planned segmental uterine resection.

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来源期刊
Obstetrics and Gynecology Science
Obstetrics and Gynecology Science Medicine-Obstetrics and Gynecology
CiteScore
3.80
自引率
15.80%
发文量
58
审稿时长
16 weeks
期刊介绍: Obstetrics & Gynecology Science (NLM title: Obstet Gynecol Sci) is an international peer-review journal that published basic, translational, clinical research, and clinical practice guideline to promote women’s health and prevent obstetric and gynecologic disorders. The journal has an international editorial board and is published in English on the 15th day of every other month. Submitted manuscripts should not contain previously published material and should not be under consideration for publication elsewhere. The journal has been publishing articles since 1958. The aim of the journal is to publish original articles, reviews, case reports, short communications, letters to the editor, and video articles that have the potential to change the practices in women''s health care. The journal’s main focus is the diagnosis, treatment, prediction, and prevention of obstetric and gynecologic disorders. Because the life expectancy of Korean and Asian women is increasing, the journal''s editors are particularly interested in the health of elderly women in these population groups. The journal also publishes articles about reproductive biology, stem cell research, and artificial intelligence research for women; additionally, it provides insights into the physiology and mechanisms of obstetric and gynecologic diseases.
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