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低资源和中等资源环境下异常性胎盘植入的管理。

Management of abnormal invasive placenta in a low- and medium-resource setting.

机构信息

Department of Telemedicine, Fundación Valle del Lili, Cali, Colombia; Department of Obstetrics and Gynecology, High Complexity Obstetric Unit, Fundación Valle del Lili, Cali, Colombia.

Department of Obstetrics and Gynecology, High Complexity Obstetric Unit, Fundación Valle del Lili, Cali, Colombia.

出版信息

Best Pract Res Clin Obstet Gynaecol. 2021 Apr;72:117-128. doi: 10.1016/j.bpobgyn.2020.08.004. Epub 2020 Aug 13.

Abstract

The purpose of this review is to describe the panorama of placenta accreta spectrum (PAS) disorder management in low- and middle-income countries, providing information that allows for the improvement of maternal and perinatal outcomes in the management of this pathology. This spectrum of disorders is associated with implications of high morbidity and mortality, both maternal and perinatal, which is why clinical practice guidelines based on management are produced in settings where there is a wide range of available resources. This situation often contrasts with what the reality is in low-resource countries. Prenatal diagnosis of placental accreta is essential to carry out adequate surgical planning in centres where multidisciplinary teams are in place, which improve results and reduce complications. These ideal scenarios should be developed in countries with more significant difficulties in the availability of human and technological resources, through teamwork in the different hospital centres and the adequate transfer of patients at higher risk to centres with the best interdisciplinary management skills.

摘要

本篇综述的目的在于阐述中低收入国家胎盘植入谱系疾病(PAS)的处理全景,提供相关信息,以期改善该疾病处理过程中的母婴结局。该谱系疾病与高发病率和死亡率(孕产妇和围产儿)相关,因此,在资源种类广泛的情况下,会制定基于处理方法的临床实践指南。这种情况通常与资源匮乏国家的实际情况形成鲜明对比。胎盘植入的产前诊断对于在具备多学科团队的中心进行充分的手术规划至关重要,这可以改善结果并减少并发症。在人力资源和技术资源更为匮乏的国家,应通过不同医院中心之间的团队合作以及将高危患者适当转移到具有最佳跨学科管理技能的中心,来发展这些理想的场景。

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