Department of Obstetrics and Gynaecology, St. George's University of London, UK.
Acta Obstet Gynecol Scand. 2010 Sep;89(9):1126-33. doi: 10.3109/00016349.2010.503869.
Abstract Morbidly adherent placenta is often associated with severe maternal morbidity. An increased incidence over the recent years may be secondary to the increased cesarean section rates. Identification of patients with risk factors antenatally is essential for the early diagnosis and management. Diagnosis can be achieved by ultrasound or MRI in the majority of cases. Management aims to ensure a safe delivery of the fetus, alongside measures of prevention or effective management of postpartum hemorrhage. When a hysterectomy is performed, a multidisciplinary team with surgical expertise and facilities for transfusion and further interventions including arterial ligation and interventional radiology should be available. The options for conservative treatments offer the potential to preserve fertility but further research with prospective evaluation of the different approaches is necessary.
摘要 胎盘粘连/植入通常与严重的产妇发病率相关。近年来发病率增加可能与剖宫产率增加有关。产前识别有风险的患者对于早期诊断和管理至关重要。大多数情况下,超声或 MRI 可以进行诊断。管理的目的是确保胎儿安全分娩,并采取预防或有效管理产后出血的措施。如果需要进行子宫切除术,应具备外科专业知识的多学科团队,以及输血和进一步干预的设施,包括动脉结扎和介入放射学。保守治疗的选择有保留生育能力的潜力,但需要进一步研究,前瞻性评估不同方法。