Ahmed Salah Roshdy, Aitallah Abdusaeed, Abdelghafar Hazem M, Alsammani Mohamed Alkhatim
Professor, Department of Obstetrics and Gynecology, Sohag University , Egypt .
Assistant Professor, Department of Obstetrics and Gynecology, Sohag University , Egypt .
J Clin Diagn Res. 2015 Nov;9(11):QC17-9. doi: 10.7860/JCDR/2014/14930.6831. Epub 2015 Nov 1.
Major degree placenta is a serious health issue and is associated with high fetal-maternal morbidity and mortality. Literature from developing countries is scant.
To determine the prevalence and maternal and neonatal outcomes among women with major placenta previa (PP).
A prospective descriptive study of 52 singleton pregnancies with PP was evaluated in this study. The study was conducted at Sohag University Hospital, Egypt from January through June 2014. Outcome measures, including the prevalence of PP, maternal and neonatal outcomes, and case-fatality rate.
The total number of deliveries performed during the study period was 3841, of them, 52 cases were placenta previa. Thus, the prevalence of PP was 1.3%. The mean of previous cesarean scars was 2.2±1.4. Of women with PP, 26.4% (n=14) had placenta accreta. In total, 15.1% (n=8) of women underwent an obstetric hysterectomy. From the total no. of babies, 13.2% (n=7) were delivered fresh stillborn babies. Of the surviving babies (n=45), 20% (n=9) required admission to NICU. The frequencies of bowel and bladder injuries were 3.8% (n=2) and 13.2% (n=7) respectively. There was no maternal death in this study.
The rate of PP is comparable to previous studies, however, the rate of placenta accreta is high. Also, there are high rates of neonatal mortality and intraoperative complications which can be explained by accreta. The study highlights the need to revise maternity and child health services.
重度胎盘异常是一个严重的健康问题,与母婴高发病率和死亡率相关。来自发展中国家的相关文献较少。
确定重度前置胎盘(PP)女性的患病率以及母婴结局。
本研究对52例单胎妊娠合并PP进行了前瞻性描述性研究。该研究于2014年1月至6月在埃及索哈杰大学医院开展。观察指标包括PP的患病率、母婴结局及病死率。
研究期间共进行了3841例分娩,其中52例为前置胎盘。因此,PP的患病率为1.3%。既往剖宫产瘢痕的平均数为2.2±1.4。PP女性中,26.4%(n = 14)发生胎盘植入。总计15.1%(n = 8)的女性接受了产科子宫切除术。在所有婴儿中,13.2%(n = 7)为死产儿。在存活婴儿(n = 45)中,20%(n = 9)需要入住新生儿重症监护病房。肠道和膀胱损伤的发生率分别为3.8%(n = 2)和13.2%(n = 7)。本研究中无孕产妇死亡。
PP的发生率与既往研究相当,然而,胎盘植入的发生率较高。此外,新生儿死亡率和术中并发症发生率也较高,这可能与胎盘植入有关。该研究强调了修订母婴健康服务的必要性。