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胎盘植入谱系疾病的病因发病机制和危险因素。

Etiopathogenesis and risk factors for placental accreta spectrum disorders.

机构信息

St George's University Hospitals NHS Foundation Trust, Blackshaw Road, London, SW17 0QT, UK.

Global Academy of Medical Education & Training, Office 4, 219 Kensington High Street, Kensington, London, England, W8 6BD, UK.

出版信息

Best Pract Res Clin Obstet Gynaecol. 2021 Apr;72:4-12. doi: 10.1016/j.bpobgyn.2020.07.006. Epub 2020 Jul 15.

Abstract

Placenta accreta spectrum (PAS) disorders, comprising placenta accreta, increta, and percreta, are associated with serious maternal morbidity and mortality in both the developed and the developing world. The incidence of PAS has increased in the recent years, and the rising rates of cesarean section rate, placenta accreta in previous pregnancies, and other uterine surgeries including myomectomies and repeated endometrial curettage are implicated in its etiopathogenesis. The absolute risk of PAS increases with the number of previous cesarean sections. The PAS remains undiagnosed in one-half to two-thirds of cases, thus increasing maternal morbidity and mortality. Understanding etiopathogenesis and risk factors of this condition allows early diagnosis and planning of delivery, and thereby would help improve maternal and fetal outcomes.

摘要

胎盘植入谱系(PAS)疾病,包括胎盘粘连、胎盘植入和胎盘穿透,与发达国家和发展中国家的严重产妇发病率和死亡率有关。近年来,PAS 的发病率有所增加,剖宫产率上升、既往妊娠胎盘植入以及包括子宫肌瘤切除术和反复子宫内膜刮宫术在内的其他子宫手术都与该病的病因学有关。PAS 的绝对风险随着既往剖宫产次数的增加而增加。有一半到三分之二的 PAS 病例未被诊断,从而增加了产妇的发病率和死亡率。了解 PAS 的病因学和危险因素有助于早期诊断和分娩计划,从而有助于改善母婴结局。

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