Carusi Daniela A
Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts.
Clin Obstet Gynecol. 2018 Dec;61(4):733-742. doi: 10.1097/GRF.0000000000000391.
The placenta accreta spectrum has become an important contributor to severe maternal morbidity. The true incidence is difficult to ascertain, but likely falls near 1/1000 deliveries. This number seems to have increased along with the rate of risk factors. These include placenta previa, previous cesarean section, use of assisted reproductive technologies, uterine surgeries, and advanced maternal age. With increased uterine conservation, previous retained placenta or placenta accreta have become significant risk factors. Understanding placenta accreta spectrum risk factors facilitates patient identification and safe delivery planning. Patients considering elective uterine procedures or delayed childbirth should consider the impact on peripartum morbidity.
胎盘植入谱系已成为导致孕产妇严重发病的一个重要因素。其真实发病率难以确定,但可能接近千分之一的分娩率。随着风险因素发生率的上升,这一数字似乎也有所增加。这些因素包括前置胎盘、既往剖宫产史、辅助生殖技术的使用、子宫手术以及高龄产妇。随着子宫保留手术的增加,既往胎盘残留或胎盘植入已成为重要的风险因素。了解胎盘植入谱系的风险因素有助于识别患者并制定安全的分娩计划。考虑选择性子宫手术或延迟分娩的患者应考虑对围产期发病率的影响。