Kathpalia Sukesh, Kshirsagar Shilpa, Kulkarni Manasvi, Pandey Rakshit, Kulkarni Jayshree
Obstetrics and Gynaecology, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pune, IND.
Medicine, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pune, IND.
Cureus. 2024 Aug 20;16(8):e67316. doi: 10.7759/cureus.67316. eCollection 2024 Aug.
Introduction Caesarean section (CS) is a lifesaving operation; it can have many complications in subsequent pregnancies. Since the uterine wall and cavity are not normal after CS, the implantation and subsequent trophoblastic invasion and placenta formation may be affected. This study was carried out to find out implantation and placental problems encountered in subsequent pregnancies. The spectrum includes placenta accreta, increta, and percreta and is characterized microscopically by a complete or partial absence of decidua and placental adherence to or invasion of the myometrium. The study was performed to find out the complications of CS in subsequent pregnancies and take measures to detect them early and take appropriate action. Materials and methods This retrospective study was carried out at Dr. D.Y. Patil Medical College and Research Centre Pimpri, Dr DY Patil Vidyapeeth, a large tertiary care centre. Many complications like placenta previa, adherent placenta, ectopic pregnancy, obstetrical hysterectomy, etc, the ones directly related to implantation and placentation, were recorded and compared with the literature. Results and observations The study was over a period of three years. During this period, there were 10,296 antenatal cases registered; of all the registered cases, 2,544 were cases of post-caesarean pregnancy. There were three cases of tubal ectopic pregnancy, two were diagnosed as the patients complained of amenorrhoea, spotting, and pain abdomen, confirmed on sonography and one was picked up on a routine first-trimester scan. There were two cases of scar ectopic pregnancy. Both the cases were diagnosed as threatened abortion initially and ultrasound confirmed the diagnosis; both were managed medically. Five cases of placenta previa were encountered. There were three cases of morbidly adherent placenta, and two cases underwent obstetrical hysterectomy. Conclusion All surgical procedures have become safe, but they all have some complications. Many complications in the next pregnancy after caesarean are life-threatening and dangerous. These complications should be detected early to prevent any catastrophic event.
引言 剖宫产是一种挽救生命的手术；它在后续妊娠中可能会引发许多并发症。由于剖宫产术后子宫壁和宫腔不正常，胚胎着床以及随后的滋养层细胞侵入和胎盘形成可能会受到影响。本研究旨在找出后续妊娠中遇到的着床和胎盘问题。其范围包括胎盘植入、穿透性胎盘植入和完全性胎盘植入，微观特征为蜕膜完全或部分缺失以及胎盘附着于子宫肌层或侵入子宫肌层。本研究旨在找出剖宫产术后后续妊娠的并发症，并采取措施尽早发现并采取适当行动。
材料与方法 本回顾性研究在大型三级医疗中心皮姆普里的迪帕克·帕蒂尔医学院及研究中心、迪帕克·帕蒂尔大学进行。记录了许多与着床和胎盘形成直接相关的并发症，如前置胎盘、粘连性胎盘、异位妊娠、产科子宫切除术等，并与文献进行了比较。
结果与观察 本研究为期三年。在此期间，共登记了10296例产前病例；在所有登记病例中，有2544例为剖宫产后妊娠。有3例输卵管异位妊娠，其中2例因患者主诉闭经、点滴出血和腹痛而被诊断出，经超声检查确诊，1例在孕早期常规扫描时被发现。有2例瘢痕部位异位妊娠。这2例最初均被诊断为先兆流产，超声检查确诊；均采用药物治疗。共遇到5例前置胎盘。有3例胎盘植入，其中2例行产科子宫切除术。
结论 所有外科手术都已变得安全，但它们都会有一些并发症。剖宫产术后下一胎妊娠的许多并发症都危及生命且很危险。应尽早发现这些并发症以防止任何灾难性事件发生。
