Atallah David, Moubarak Malak, Nassar Malek, Kassab Bernard, Ghossain Michel, El Kassis Nadine
School of Medicine, Saint Joseph University, Beirut, Lebanon.
Department of Obstetrics and Gynecology, Hôtel-Dieu de France University Hospital, Beirut, Lebanon.
Int J Gynaecol Obstet. 2018 Mar;140(3):352-356. doi: 10.1002/ijgo.12402. Epub 2017 Dec 22.
To report the outcomes of women with placenta percreta who were surgically treated by a specialized technique based on gynecologic oncology experience, and to demonstrate its safety in preventing ureteral lesions and reducing blood loss.
In the present retrospective study, data from patients with placenta percreta radically treated at Hôtel-Dieu de France, Beirut, Lebanon, between December 2012 and January 2017 were reviewed. Demographic, pathology, and delivery data, medical history, per-operative and postoperative information, and neonatal data were assessed. Operative and postoperative outcomes were compared between emergency and scheduled cases.
Data from 35 patients were reviewed. Median gestational age at delivery was 34 weeks. Cesarean hysterectomy was scheduled in 20 (60%) cases. No ureteral lesions were noted. The median estimated blood loss was 1 L and a median of 3 units of red blood cells units was transfused. Emergency and scheduled cases presented comparable estimated blood loss, intra-operative transfusion, bladder injury incidence, and surgery duration (all P>0.05). The mean delivery weight was 2100 g; admission to the neonatal intensive care unit was needed for 30 (86%) neonates.
The surgical technique developed for placenta percreta was found to be effective (operative and postoperative outcomes) and safe (prevention of ureteral lesions).
报告采用基于妇科肿瘤学经验的专门技术对穿透性胎盘植入妇女进行手术治疗的结果，并证明其在预防输尿管损伤和减少失血方面的安全性。
在本回顾性研究中，回顾了2012年12月至2017年1月在黎巴嫩贝鲁特法国主宫医院接受根治性治疗的穿透性胎盘植入患者的数据。评估了人口统计学、病理学和分娩数据、病史、手术中和术后信息以及新生儿数据。比较了急诊和择期病例的手术和术后结果。
回顾了35例患者的数据。分娩时的中位孕周为34周。20例（60%）计划行剖宫产子宫切除术。未发现输尿管损伤。估计失血量中位数为1升，红细胞输注中位数为3单位。急诊和择期病例的估计失血量、术中输血、膀胱损伤发生率和手术持续时间相当（均P>0.05）。平均出生体重为2100克；30例（86%）新生儿需要入住新生儿重症监护病房。
为穿透性胎盘植入开发的手术技术被发现是有效的（手术和术后结果）和安全的（预防输尿管损伤）。
