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胎盘植入谱系疾病与产后出血。

Placenta Accreta Spectrum and Postpartum Hemorrhage.

机构信息

Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio.

出版信息

Clin Obstet Gynecol. 2023 Jun 1;66(2):399-407. doi: 10.1097/GRF.0000000000000783. Epub 2023 Apr 27.

Abstract

Placenta accreta spectrum is a group of disorders involving abnormal trophoblastic invasion to the deep layers of endometrium and myometrium. Placenta accrete spectrum is one of the major causes of severe maternal morbidity, with increasing incidence in the past decade mainly secondary to an increase in cesarean deliveries. Severity varies depending on the depth of invasion, with the most severe form, known as percreta, invading uterine serosa or surrounding pelvic organs. Diagnosis is usually achieved by ultrasound, and MRI is sometimes used to assess invasion. Management usually involves a hysterectomy at the time of delivery. Other strategies include delayed hysterectomy or expectant management.

摘要

胎盘植入谱系疾病是一组涉及异常滋养细胞浸润到子宫内膜和子宫肌层深层的疾病。胎盘植入谱系疾病是导致严重产妇发病率的主要原因之一,过去十年发病率的增加主要与剖宫产率的增加有关。疾病的严重程度取决于浸润的深度,最严重的形式,称为胎盘穿透,侵犯子宫浆膜或周围盆腔器官。诊断通常通过超声检查来实现,磁共振成像(MRI)有时用于评估浸润程度。治疗通常在分娩时进行子宫切除术。其他策略包括延迟子宫切除术或期待治疗。

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