Women-Mother-Child Department, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
J Invest Surg. 2021 Feb;34(2):172-180. doi: 10.1080/08941939.2019.1623956. Epub 2019 Aug 20.
In the last 30 years, with increasing cesarean section rates, the incidence of the placenta accreta spectrum has also increased. It is estimated that by the year 2020 there will be nearly 9000 cases annually in the United States. Currently, no consensus exists regarding optimal management. Conventional treatment by cesarean-hysterectomy is challenging, with a high maternal morbidity due to massive hemorrhage, and surgical complications such as urinary tract, bowel and pelvic nerve injury, in addition to loss of fertility and its accompanying psychological trauma. Innovative approaches seek to preserve the uterus with the adherent placenta , thus maintaining fertility and potentially reducing hemorrhage and adjacent organ injury. This review reports strategies for conservative treatment of such conditions, based on the current literature.
在过去的 30 年中，随着剖宫产率的不断上升，胎盘植入谱系疾病的发病率也有所增加。据估计，到 2020 年，美国每年将有近 9000 例病例。目前，对于最佳治疗方法尚未达成共识。传统的剖宫产-子宫切除术治疗方法具有挑战性，由于大量出血，产妇发病率高，并且存在手术并发症，如尿路、肠道和骨盆神经损伤，此外还丧失了生育能力及其伴随的心理创伤。创新性方法旨在保留附着胎盘的子宫，从而保持生育能力，并可能减少出血和邻近器官损伤。本综述根据当前文献报告了此类疾病的保守治疗策略。
