Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, United States.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, United States.
Semin Perinatol. 2019 Feb;43(1):51-59. doi: 10.1053/j.semperi.2018.11.009. Epub 2018 Nov 15.
The term "morbidly adherent placenta" has recently been introduced to describe the spectrum of disorders including placenta accreta, increta and percreta. Due to excessive invasion of the placenta into the uterus there is associated significant maternal morbidity and mortality. Most significant risk factors for morbidly adherent placenta include history of prior cesarean delivery as well as placenta previa in the current pregnancy. Ultrasound remains the gold standard for antenatal diagnosis, however, in recent years MRI has assisted in identifying complex parametrial involvement. Optimizing maternal and neonatal outcomes involves early prenatal diagnosis, a multi-disciplinary team-based approach, and referral to an experienced center.
“病态粘连胎盘”一词最近被引入,用于描述包括胎盘粘连、胎盘植入和胎盘穿透在内的一系列疾病。由于胎盘过度侵入子宫,会导致产妇发病率和死亡率显著增加。病态粘连胎盘的主要危险因素包括既往剖宫产史和当前妊娠的前置胎盘。超声仍然是产前诊断的金标准,但近年来 MRI 有助于识别复杂的宫旁受累。优化母婴结局需要进行早期产前诊断、采用多学科团队方法,并转至有经验的中心。