Lachman E, Mali A, Gino G, Burstein M, Stark M
Dept. of Obstetrics and Gynecology, Misgav Ladach Hospital, Jerusalem.
Harefuah. 2000 Apr 16;138(8):628-31, 712.
The increased rate of cesarean sections in recent decades has brought with it an increase in the frequency of placenta accreta. There are direct correlations between previous cesarean deliveries and also maternal age, with the risk of placenta accreta. There is also a direct correlation between placenta accreta and placenta previa. The risk of placenta accreta in women who have had placenta previa is 2% for those younger than 35 years and with no history of uterine surgery. The risk increases to 39% for those over 35 who have had 2 or more cesarean sections. We present 3 cases of placenta accreta admitted in 15 months, all of whom had a history of cesarean sections. The frequency of placenta accreta in our hospital is 1:1,579 deliveries, in line with the 1:1,420 in the literature. We consider hysterectomy the treatment of choice for this serious complication. When performing a cesarean in cases of placenta previa with a history of cesarean sections, the possibility of placenta accreta should be considered.
近几十年来剖宫产率的上升导致胎盘植入的发生率增加。既往剖宫产分娩以及产妇年龄与胎盘植入风险之间存在直接关联。胎盘植入与前置胎盘之间也存在直接关联。对于年龄小于35岁且无子宫手术史的前置胎盘女性，胎盘植入风险为2%。对于年龄超过35岁且有2次或更多次剖宫产史的女性，风险增至39%。我们呈现了15个月内收治的3例胎盘植入病例，所有患者均有剖宫产史。我院胎盘植入的发生率为1:1579次分娩，与文献报道的1:1420相符。我们认为子宫切除术是治疗这种严重并发症的首选方法。对于有剖宫产史的前置胎盘病例进行剖宫产时，应考虑胎盘植入的可能性。
