胎盘植入谱系疾病治疗中是否有必要施行以家庭为中心的剖宫产？
Is There a Place for Family-centered Cesarean Delivery during Placenta Accreta Spectrum Treatment?
机构信息
Clínica de Espectro de Acretismo Placentario, Fundación Valle del Lili, Cali, Colombia.
Universidad Icesi, Programa de Medicina, Cali, Colombia.
出版信息
Rev Bras Ginecol Obstet. 2022 Oct;44(10):925-929. doi: 10.1055/s-0042-1751060. Epub 2022 Sep 6.
OBJECTIVE
Placenta accreta spectrum (PAS) is a cause of massive obstetric hemorrhage and maternal mortality. The application of family-centered delivery techniques (FCDTs) during surgery to treat this disease is infrequent. We evaluate the implementation of FCDTs during PAS surgeries.
METHODS
This was a prospective, descriptive study that included PAS patients undergoing surgical management over a 12-month period. The patients were divided according to whether FCDTs were applied (group 1) or not (group 2), and the clinical outcomes were measured. In addition, hospital anesthesiologists were surveyed to evaluate their opinions regarding the implementation of FCDTs during the surgical management of PAS.
RESULTS
Thirteen patients with PAS were included. The implementation of FCDTs during birth was possible in 53.8% of the patients. The presence of a companion during surgery and skin-to-skin contact did not hinder interdisciplinary management in any case.
CONCLUSION
Implementation of FCDTs during PAS care is possible in selected patients at centers with experience in managing this disease.
目的
胎盘植入谱系疾病（PAS）是导致产科大出血和产妇死亡的一个原因。在治疗这种疾病的手术中，应用以家庭为中心的分娩技术（FCDTs）并不常见。我们评估了在 PAS 手术中应用 FCDTs 的情况。
方法
这是一项前瞻性描述性研究，纳入了在 12 个月期间接受手术治疗的 PAS 患者。根据是否应用了 FCDTs（第 1 组）或未应用（第 2 组），将患者进行分组，并测量了临床结果。此外，还对医院麻醉师进行了调查，以评估他们对在 PAS 手术管理中实施 FCDTs 的意见。
结果
共纳入 13 例 PAS 患者。在 53.8%的患者中，能够在分娩过程中实施 FCDTs。在手术过程中有陪伴者和皮肤接触在任何情况下都没有妨碍跨学科管理。
结论
在有管理 PAS 疾病经验的中心，在选定的患者中，在 PAS 护理过程中实施 FCDTs 是可行的。
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