Zhang Huijing, Dou Ruochong, Yang Huixia, Zhao Xianlan, Chen Dunjin, Ding Yilin, Ding Hongjuan, Cui Shihong, Zhang Weishe, Xin Hong, Gu Weirong, Hu Yali, Ding Guifeng, Qi Hongbo, Fan Ling, Ma Yuyan, Lu Junli, Yang Yue, Lin Li, Luo Xiucui, Zhang Xiaohong, Fan Shangrong
a Department of Obstetrics and Gynaecology , Peking University First Hospital , Beijing , China.
J Matern Fetal Neonatal Med. 2019 Aug;32(16):2622-2627. doi: 10.1080/14767058.2018.1442429. Epub 2018 Mar 7.
The objective of this study is to identify the maternal and neonatal outcomes in women with placenta increta or placenta percreta in China.
We retrospectively analyzed 2219 cases from 20 tertiary care centers in China between January 2011 and December 2015. All cases were diagnosed of placenta increta or placenta percreta, based on either intraoperative findings or histopathological findings.
The incidence of placenta increta and placenta percreta progressively increased from 0.18% in 2011 to 0.78% in 2015. Compared with the placenta increta, placenta percreta was strongly related to serious adverse outcomes: postpartum hemorrhage (65.9% versus 38.6%, p = .003), blood transfusion (86.2% versus 46.5%, p < .001), hysterectomy (43.3% versus 11.2%, p < .001), preterm birth (65.7% versus 49.9%, p < .001), and the need for neonatal intensive care unit (NICU) admission (54.5% versus 36.7%, p < .001).
The incidence of placenta increta and placenta percreta is likely to increase in China. The depth of placenta implantation is associated with the severity of outcomes. Placenta percreta tends to have worse maternal and neonatal outcomes.
本研究的目的是确定中国胎盘植入或穿透性胎盘植入女性的母婴结局。
我们回顾性分析了2011年1月至2015年12月期间来自中国20家三级护理中心的2219例病例。所有病例均根据术中发现或组织病理学发现诊断为胎盘植入或穿透性胎盘植入。
胎盘植入和穿透性胎盘植入的发生率从2011年的0.18%逐渐上升至2015年的0.78%。与胎盘植入相比,穿透性胎盘植入与严重不良结局密切相关:产后出血(65.9%对38.6%,p = 0.003)、输血(86.2%对46.5%,p < 0.001)、子宫切除术(43.3%对11.2%,p < 0.001)、早产(65.7%对49.9%,p < 0.001)以及新生儿重症监护病房(NICU)收治需求(54.5%对36.7%,p < 0.001)。
中国胎盘植入和穿透性胎盘植入的发生率可能会上升。胎盘植入深度与结局严重程度相关。穿透性胎盘植入往往会导致更差的母婴结局。