Makhseed M, el-Tomi N, Moussa M
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Kuwait, Safat.
Int J Gynaecol Obstet. 1994 Nov;47(2):127-34. doi: 10.1016/0020-7292(94)90352-2.
To determine the incidence of pathologically implanted placenta, i.e. placenta previa and accreta, at the Maternity Hospital of Kuwait. In addition the study aimed to identify the risk factors for such conditions, and test the hypothesis that previous cesarean section increases the likelihood of abnormal placentation.
Analysis of all deliveries in the Maternity Hospital of Kuwait with identification of cases of placenta previa, placenta accreta, previous cesarean section and manual removal of placenta. Information was obtained from the medical records of the hospital between 1981 and 1992 except for the period 1990-1991 due to incomplete information as a consequence of the Iraqi invasion. The incidences of these conditions were calculated followed by identification of risk factors for placenta accreta and previa.
The incidence of placenta previa was 0.5% and that of placenta accreta 9.5 per 100,000 deliveries. Placenta previa and previous cesarean section were found to be significant predisposing factors for placenta accreta. The increased risk for placenta accreta in the presence of these factors was much less than that reported in the international literature. Abnormal placentation was responsible for 34% of peripartum hysterectomies.
Placenta accreta and previa are major causes of massive obstetric hemorrhage. They are interrelated with a common predisposing factor, cesarean section. Even though the rate of cesarean section and placenta previa is increasing, the incidence of placenta accreta remains stable in Kuwait.
确定科威特妇产医院病理性植入胎盘（即前置胎盘和胎盘植入）的发生率。此外，该研究旨在识别这些情况的风险因素，并检验既往剖宫产会增加胎盘植入异常可能性这一假设。
对科威特妇产医院的所有分娩病例进行分析，识别前置胎盘、胎盘植入、既往剖宫产和人工剥离胎盘的病例。除1990 - 1991年期间因伊拉克入侵导致信息不完整外，从1981年至1992年的医院病历中获取信息。计算这些情况的发生率，随后识别胎盘植入和前置胎盘的风险因素。
前置胎盘的发生率为0.5%，胎盘植入的发生率为每10万例分娩9.5例。前置胎盘和既往剖宫产被发现是胎盘植入的重要诱发因素。在存在这些因素的情况下，胎盘植入风险增加的幅度远低于国际文献报道。异常胎盘植入导致34%的围产期子宫切除术。
胎盘植入和前置胎盘是产科大出血的主要原因。它们与一个共同的诱发因素剖宫产相关。尽管科威特的剖宫产率和前置胎盘发生率在上升，但胎盘植入的发生率保持稳定。
