Department of Obstetrics and Gynecology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
Med Sci Monit. 2023 Mar 29;29:e939326. doi: 10.12659/MSM.939326.
BACKGROUND Placenta previa is defined as a placenta that grows from the anterior or posterior wall of the uterus and covers the cervix. The incidence of placenta previa has been increasing in recent years. It is thought that bleeding is more common during surgery in cases with anterior placenta that is closing the cervix. This study investigated the importance of placental location in pregnant women with placenta previa who had a previous cesarean section. MATERIAL AND METHODS This study covered the period from July 2017 to June 2020. The 116 patients included in the study were divided into 2 groups according to placental location: anterior (group 1) and posterior (group 2). All patients had previously delivered via cesarean section. Operation time, presence of invasion, estimated blood loss during surgery, and transfused erythrocyte volume were evaluated. Medical records were used to access the relevant data. RESULTS The patients in group 1 and group 2 had an average of 2.71 and 2.01 previous cesarean sections, respectively (P=0.002). The placental invasion (percreta) rate was significantly higher in group 1 than in group 2 (65.4 vs 5.3%, P<0.001), as was the estimated blood loss during surgery (790 vs 527 mL, P=0.014). The total erythrocyte suspension was considerably higher in group 1 than in group 2 patients (0.8 vs 0.2, P=0.014), both during and after surgery. CONCLUSIONS In patients with placenta previa, the location of the placenta should always be examined with ultrasonography to allow better preoperative planning.
前置胎盘是指胎盘从子宫的前壁或后壁生长并覆盖宫颈。近年来，前置胎盘的发病率一直在上升。人们认为，在覆盖宫颈的前壁胎盘剖宫产术中，出血更为常见。本研究调查了既往行剖宫产术的前置胎盘孕妇胎盘位置的重要性。
本研究涵盖了 2017 年 7 月至 2020 年 6 月的时间段。根据胎盘位置，将纳入研究的 116 例患者分为两组：前壁（组 1）和后壁（组 2）。所有患者均行剖宫产术分娩。评估手术时间、有无胎盘植入、术中估计失血量和输血量。使用病历查阅相关数据。
组 1 和组 2 的患者分别有 2.71 次和 2.01 次剖宫产史（P=0.002）。组 1 的胎盘植入（穿透性胎盘）率明显高于组 2（65.4%比 5.3%，P<0.001），术中估计失血量也明显多于组 2（790 比 527 毫升，P=0.014）。组 1 患者术中及术后总红细胞悬液输注量明显多于组 2（0.8 比 0.2，P=0.014）。
对于前置胎盘患者，应始终通过超声检查检查胎盘位置，以便更好地进行术前规划。
