Papanikolaou Ioannis G, Domali Ekaterini, Daskalakis George, Theodora Marianna, Telaki Eirini, Drakakis Petros, Loutradis Dimitrios
1(st) Department of Obstetrics & Gynecology, "Alexandra" Hospital, University of Athens, Medical School, Greece(1).
1(st) Department of Obstetrics & Gynecology, "Alexandra" Hospital, University of Athens, Medical School, Greece(1).
Eur J Obstet Gynecol Reprod Biol. 2018 Sep;228:98-105. doi: 10.1016/j.ejogrb.2018.06.004. Epub 2018 Jun 5.
Abnormal placentation often requires the involvement of a multidisciplinary team of medical caregivers. Practicing Obstetrics is a challenging and skillful duty. This is more obvious in cases of abnormal placentation, which represents one of the most dangerous and complex clinical conditions in materno-fetal medicine. Pathological placentation involves position and invasion abnormalities and represents a serious and potentially life-threatening condition for both the pregnant woman and the fetus. The dramatic increase in cesarean section rates is an important factor which could explain the rapid raise in abnormal placentation cases, which were considered rare a few years ago. Nevertheless, the scientific armamentarium sometimes seems to be poor and this could be explained by the fact that treatment options are offered too late, since this condition is often detected late, entailing higher patients' risks. In fact, the later the diagnosis is made the poorer the prognosis is for cases of abnormal placentation. Given that abnormal placentation is constantly increasing, the scientific community should aim at early diagnosis and appropriate management of such cases based on the best evidence available. Future improvement of knowledge and practice lies in perspective, preferably randomized studies so that we obtain high quality of evidence which is still needed. The purpose of this study is to review the current literature and to update the available scientific knowledge on the topic of abnormal placentation which is an emerging issue which clinicians should learn to deal with, considering its continuous increase in the last years.
异常胎盘形成通常需要多学科医疗护理团队的参与。产科实践是一项具有挑战性且需要技巧的工作。在异常胎盘形成的情况下，这一点更为明显，异常胎盘形成是母胎医学中最危险、最复杂的临床病症之一。病理性胎盘形成涉及位置和侵入异常，对孕妇和胎儿来说都是一种严重且可能危及生命的情况。剖宫产率的急剧上升是一个重要因素，这可以解释异常胎盘形成病例的迅速增加，而几年前这种情况还被认为很罕见。然而，科学手段有时似乎很匮乏，这可以用以下事实来解释：治疗选择提供得太晚，因为这种病症往往发现得晚，会给患者带来更高的风险。事实上，异常胎盘形成病例的诊断越晚，预后就越差。鉴于异常胎盘形成的情况在不断增加，科学界应以现有最佳证据为基础，致力于此类病例的早期诊断和恰当管理。未来知识和实践的改进很有前景，最好是进行随机研究，以便我们获得仍需的高质量证据。本研究的目的是回顾当前文献，并更新关于异常胎盘形成这一新兴问题的现有科学知识，考虑到其在过去几年中持续增加的情况，临床医生应学会应对这一问题。
