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妊娠间隔与异常侵袭性胎盘。

Interpregnancy interval and abnormally invasive placentation.

机构信息

Department of Maternal Fetal Medicine and Surgery, Hackensack University Medical Center, Hackensack, NJ, USA.

Department of Obstetrics, Gynecology and Women's Health, Rutgers New Jersey Medical School, Newark, NJ, USA.

出版信息

Acta Obstet Gynecol Scand. 2019 Feb;98(2):183-187. doi: 10.1111/aogs.13478. Epub 2018 Nov 2.

DOI:10.1111/aogs.13478
PMID:30288733
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6428064/
Abstract

INTRODUCTION

The presence of a previous uterine scar is a strong risk factor for developing abnormally invasive placentation (AIP). We sought to determine whether a short interpregnancy interval predisposes to AIP. We hypothesized that a short interpregnancy interval after a previous cesarean delivery increases the risk of AIP in comparison with a longer interpregnancy interval.

MATERIAL AND METHODS

We performed a retrospective cohort study of women with a histological diagnosis of AIP and a history of a previous cesarean section. Women were included in the control group if they had a previous cesarean section with a placenta underlying the previous uterine scar or an anterior previa. The time interval between pregnancy and AIP data was analyzed using the chi-square test and two-tailed Fisher's exact test.

RESULTS

There was no statistical difference in the interpregnancy interval between women who had AIP vs the control group. Gravidity and parity were found to be significantly higher in the women with AIP vs the controls.

CONCLUSIONS

These results suggest that a short interpregnancy interval may not increase the risk of developing AIP.

摘要

简介

既往子宫瘢痕是异常侵袭性胎盘(AIP)发生的强烈危险因素。我们旨在确定妊娠间隔时间过短是否会导致 AIP。我们假设与较长的妊娠间隔相比,既往剖宫产术后的妊娠间隔时间过短会增加 AIP 的风险。

材料与方法

我们对既往有剖宫产史且有 AIP 组织学诊断史的妇女进行了回顾性队列研究。如果妇女既往有剖宫产史且胎盘附着于既往子宫瘢痕或前置胎盘,则将其纳入对照组。使用卡方检验和双侧 Fisher 确切概率法分析妊娠与 AIP 数据之间的时间间隔。

结果

AIP 组与对照组之间的妊娠间隔时间无统计学差异。AIP 组的孕次和产次明显高于对照组。

结论

这些结果表明,妊娠间隔时间过短可能不会增加发生 AIP 的风险。

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Histopathology of Placenta Creta: Chorionic Villi Intrusion into Myometrial Vascular Spaces and Extravillous Trophoblast Proliferation are Frequent and Specific Findings With Implications for Diagnosis and Pathogenesis.胎盘植入的组织病理学:绒毛膜绒毛侵入子宫肌层血管间隙和绒毛外滋养层细胞增殖是常见且具有特异性的表现,对诊断和发病机制具有重要意义。
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Committee opinion no. 529: placenta accreta.委员会意见第 529 号:胎盘植入。
Obstet Gynecol. 2012 Jul;120(1):207-11. doi: 10.1097/AOG.0b013e318262e340.
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Placenta accreta.胎盘植入
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Risk of uterine rupture associated with an interdelivery interval between 18 and 24 months.18 至 24 个月分娩间隔与子宫破裂风险的相关性。
Obstet Gynecol. 2010 May;115(5):1003-1006. doi: 10.1097/AOG.0b013e3181d992fb.
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Placenta accreta and cesarean scar pregnancy: overlooked costs of the rising cesarean section rate.胎盘植入和剖宫产瘢痕妊娠:剖宫产率上升被忽视的代价。
Clin Perinatol. 2008 Sep;35(3):519-29, x. doi: 10.1016/j.clp.2008.07.003.
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First-trimester diagnosis and management of pregnancies implanted into the lower uterine segment Cesarean section scar.孕早期植入子宫下段剖宫产瘢痕处妊娠的诊断与处理
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