Makhseed M, Moussa M A
Department of Obstetrics & Gynaecology, Faculty of Medicine, Safat, Kuwait.
Eur J Obstet Gynecol Reprod Biol. 1999 Oct;86(2):159-63. doi: 10.1016/s0301-2115(99)00064-0.
The purpose of this retrospective study was to compare maternal and neonatal outcome in relation to site of placenta accreta by stratifying the site of placenta accreta into upper and lower uterine segment implantation.
Sixteen cases of placenta accreta which were reported in the Maternity Hospital of Kuwait over 11 years from January 1981 to July 1993 - (1990 and 1991 excluded) were retrospectively analyzed using the hospital medical records.
The incidence of placenta accreta was 9.8 per 100,000 deliveries. The rate of accreta in patients with placenta praevia was 880 per 100,000 placenta praevia, compared to a rate of 5 accreta per 100,000 placenta implanting in the upper uterine segment. There were no differences between accreta found in the upper segment and lower segment for maternal and neonatal mortality, maternal complication, past obstetric history and possibility of conserving the uterus. Significant differences were found in the birth weight, gestational age at birth, antenatal symptoms, time of diagnosis and mode of delivery when accreta was stratified by site of implantation.
Placenta praevia is a definite risk factor for placenta accreta. Combined abnormal penetration of placenta as in accreta and abnormality in site as in praevia does have a significant clinical implications.
本回顾性研究的目的是通过将胎盘植入部位分为子宫上段和下段植入，比较与胎盘植入部位相关的孕产妇和新生儿结局。
回顾性分析科威特妇产医院在1981年1月至1993年7月的11年间（不包括1990年和1991年）报告的16例胎盘植入病例，使用医院病历进行分析。
胎盘植入的发生率为每10万例分娩9.8例。前置胎盘患者的植入率为每10万例前置胎盘880例，相比之下，子宫上段植入胎盘的发生率为每10万例5例。在上段和下段发现的植入病例在孕产妇和新生儿死亡率、孕产妇并发症、既往产科病史以及保留子宫的可能性方面没有差异。当根据植入部位对植入病例进行分层时，在出生体重、出生孕周、产前症状、诊断时间和分娩方式方面发现了显著差异。
前置胎盘是胎盘植入的一个明确危险因素。胎盘植入时胎盘的异常穿透与前置胎盘时部位异常相结合确实具有重要的临床意义。
