Pri-Paz Shai, Fuchs Karin M, Gaddipati Sreedhar, Lu Yu-Shiang, Wright Jason D, Devine Patricia C
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032, USA.
J Matern Fetal Neonatal Med. 2013 Jul;26(10):1007-11. doi: 10.3109/14767058.2013.766711. Epub 2013 Feb 14.
To identify possible predictive factors associated with emergent delivery of antenatally diagnosed placenta accreta and to estimate association between emergent delivery and adverse maternal outcomes in comparison to elective delivery.
A retrospective study of all patients with placenta accreta diagnosed antenatally and confirmed pathologically, who were delivered between 2000 and 2010. Baseline characteristics and outcomes of emergent deliveries were compared with elective deliveries.
A total of 48 women met inclusion criteria, of which 24 (50%) were delivered emergently. 79.2% of emergent deliveries were preceded by antenatal bleeding (p = 0.0005), and 62.5% were preceded by recurrent bleeding (p = 0.001). Comparison of elective and emergent deliveries revealed no clinical significant difference in maternal outcome.
Antenatal bleeding is associated with an increased risk of emergent delivery. Emergent delivery in a tertiary care facility with immediate access to blood bank and ICU capabilities does not appear to be associated with an increased risk of adverse maternal outcomes. Consequently, some patients may be candidates for delivery later than 34 weeks of gestation.
确定与产前诊断的胎盘植入紧急分娩相关的可能预测因素，并评估紧急分娩与择期分娩相比与不良孕产妇结局之间的关联。
对2000年至2010年间所有产前诊断为胎盘植入并经病理证实的患者进行回顾性研究。将紧急分娩的基线特征和结局与择期分娩进行比较。
共有48名妇女符合纳入标准，其中24名（50%）为紧急分娩。79.2%的紧急分娩前有产前出血（p = 0.0005），62.5%的紧急分娩前有反复出血（p = 0.001）。择期分娩与紧急分娩的比较显示，孕产妇结局无临床显著差异。
产前出血与紧急分娩风险增加有关。在具备立即使用血库和重症监护病房能力的三级医疗机构进行紧急分娩似乎与不良孕产妇结局风险增加无关。因此，一些患者可能适合在妊娠34周后分娩。
