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早孕期胎盘植入谱系疾病筛查。

First-trimester screening for placenta accreta spectrum.

作者信息

Dar Pe'er, Doulaveris Georgios

机构信息

Division of Fetal Medicine and Ultrasound, Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine (Drs Dar and Doulaveris), Bronx, NY.

Division of Fetal Medicine and Ultrasound, Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine (Drs Dar and Doulaveris), Bronx, NY.

出版信息

Am J Obstet Gynecol MFM. 2024 May;6(5):101329. doi: 10.1016/j.ajogmf.2024.101329. Epub 2024 Mar 5.

Abstract

In recent years, there has been a significant rise in cases of placenta accreta spectrum, a group of life-threatening placental disorders that can arise during childbirth. Early detection plays a crucial role in facilitating meticulous delivery planning, ultimately leading to a reduction in mortality and morbidity rates and improved overall outcomes. Although third-trimester ultrasound has traditionally been the primary method for prenatal screening for placenta accreta spectrum, it often falls short in identifying cases or diagnosis is too late for optimal delivery planning. Emerging evidence has highlighted the option of early detection of placenta accreta spectrum indicators during the first trimester of pregnancy. This comprehensive review delves into our current knowledge of sonographic assessment of the uterine cervicoisthmic complex in the first trimester, examining the location and appearance of cesarean scars and exploring first-trimester screening strategies, ultimately paving the way for improved maternal and neonatal outcomes.

摘要

近年来,胎盘植入谱系疾病的病例显著增加,这是一组在分娩过程中可能出现的危及生命的胎盘疾病。早期检测在促进细致的分娩计划中起着至关重要的作用,最终降低了死亡率和发病率,并改善了整体结果。虽然传统上,三期末次超声一直是胎盘植入谱系疾病产前筛查的主要方法,但它往往无法识别病例,或者诊断为时已晚,无法进行最佳的分娩计划。新出现的证据强调了在妊娠早期检测胎盘植入谱系疾病指标的可能性。本综述深入探讨了我们目前对早孕子宫颈峡部复合体的超声评估知识,检查了剖宫产疤痕的位置和外观,并探讨了早孕筛查策略,最终为改善母婴结局铺平了道路。

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