凶险性前置胎盘：一项批判性综述。
Morbidly adherent placenta: a critical review.
作者信息
Aggarwal Richa, Suneja Amita, Vaid Neelam Bala, Yadav Ponam, Sharma Abha, Mishra Kiran
机构信息
Department of Obstetrics & Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, 110095 India ; KL-99, Kavi Nagar, Ghaziabad, UP 201002 India.
出版信息
J Obstet Gynaecol India. 2012 Feb;62(1):57-61. doi: 10.1007/s13224-012-0149-5. Epub 2012 Apr 20.
Abstract
OBJECTIVE
To evaluate the demographic profile, high risk factors, fetomaternal outcome and management options in morbidly adherent placenta (MAP).
STUDY DESIGN
Retrospective analysis.
METHODOLOGY
Review of 20 case records of women with MAP during year 2001-2006.
RESULTS
The mean age and parity of the women was 27.7 ± 4.2 years and 2.5 respectively. 70 % women had previous uterine scar, and similar number had placenta previa. 60 % women presented with antepartum hemorrhage and 20 % with retained placenta. 85 % women underwent hysterectomy with 5 % requiring internal iliac artery ligation, another 5 % partial cystectomy and 15 % bladder repair. Blood loss was between one and nine litres requiring an average of six units whole blood and 4 units FFP. There were six (30 %) maternal deaths. 55 % of the newborns were preterm and the perinatal mortality was 33.3 %.
CONCLUSION
Cesarean section and placenta previa are significant risk factors. MAP is associated with high fetomaternal morbidity and mortality.
摘要
目的
评估凶险性前置胎盘（MAP）的人口统计学特征、高危因素、母胎结局及处理方式。
研究设计
回顾性分析。
方法
回顾2001年至2006年期间20例MAP患者的病例记录。
结果
患者的平均年龄和平均产次分别为27.7±4.2岁和2.5次。70%的患者既往有子宫瘢痕，前置胎盘的比例与之相似。60%的患者出现产前出血，20%的患者胎盘滞留。85%的患者接受了子宫切除术，5%的患者需要结扎髂内动脉，5%的患者行部分膀胱切除术，15%的患者进行膀胱修补。失血量在1至9升之间，平均需要6单位全血和4单位新鲜冰冻血浆。有6例（30%）产妇死亡。55%的新生儿早产，围产儿死亡率为33.3%。
结论
剖宫产和前置胎盘是重要的危险因素。MAP与高母胎发病率和死亡率相关。
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