胎母结局与胎盘增生谱:一项横断面研究

Pooja Sharma, P. Raina, Sachit Sharma
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摘要

(1)背景:胎盘增生谱(PAS)是胎盘滋养细胞向子宫肌层及其他部位的病理性侵犯。本研究评估了我们中心PAS妇女的人口统计学特征、风险指标、胎母结局和治疗方案。(2)方法:对2019年7月至2020年9月在SMGS三级保健中心Sri Maharaja Gulab Singh医院就诊的39例胎盘增生谱患者进行回顾性研究。(3)结果:本组患者以30 ~ 35岁年龄组居多。在我们的研究中,先前的下段剖宫产(LSCS)是PAS最关键的危险因素。32名PAS患者(82.05%)接受了子宫切除术,8名患者未接受子宫切除术。28例患者需要重症监护病房(ICU)治疗,其中13例需要呼吸支持,3例因失血性休克死亡。在我们的研究中,26例(53.84%)患者发生早产,21例(53.8%)需要新生儿重症监护病房(NICU)入院,6例(15.4%)发生新生儿早期死亡和死产。(4)结论:PAS是妇女妊娠期的毁灭性事件。它导致高产妇发病率、死亡率和不良新生儿结局。PAS的关键风险指标是既往LSCS和前置胎盘。每一个同时出现这两种情况的病例都应该在高级产科医生和麻醉团队的陪同下有计划地进行手术。
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Feto–Maternal Outcome with Placenta Accreta Spectrum: A Cross-Sectional Study
(1) Background: Placenta accreta spectrum (PAS) is a pathologic invasion of the placental trophoblasts to the myometrium and beyond. This study evaluates the demographic features, risk indicators, feto–maternal outcome, and treatment options in PAS women at our center. (2) Methods: This is a retrospective study carried out in 39 patients with placenta accreta spectrum in our tertiary health care center Sri Maharaja Gulab Singh (SMGS) Hospital, from July 2019 to September 2020. (3) Results: Most patients in our study were in the 30–35 years age group. The previous lower segment Caesarean section (LSCS) was the most critical risk factor for PAS in our research. Thirty-two of the women with PAS (82.05%) had undergone a hysterectomy, and eight patients did not undergo a hysterectomy. Twenty-eight patients needed Intensive Care Unit (ICU) care, 13 of them required ventilatory support, and three of them died due to hemorrhagic shock. In our study, preterm birth occurred in 26 patients (53.84%), while 21 (53.8%) required Neonatal Intensive Care Unit (NICU) admission, and six (15.4%) had early neonatal death and stillbirth. (4) Conclusion: PAS is a devastating event in women’s pregnancy. It leads to high maternal morbidity, mortality, and adverse neonatal outcome. The critical risk indicators for PAS are previous LSCS and placenta previa. Every case with these two concurrent conditions should be operated on in a planned way in the presence of senior obstetricians and of an anesthesiology team.
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