Morbidly Adherent Placenta Treatments and Outcomes
Morbidly Adherent Placenta Treatments and Outcomes
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DOI：
10.1097/aog.0000000000000680
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发表时间：
2015-03-01
影响因子：
7.2
通讯作者：
Blackwell, Sean C.
中科院分区：
文献类型：
--
作者：
Bailit, Jennifer L.;Grobman, William A.;Blackwell, Sean C.
目的：为了描述最近的孕产妇和新生儿分娩的结果在妇女与一个病态的粘连胎盘在主要中心在美国各地，方法：本研究回顾了一个队列的115,502名妇女和他们的新生儿出生在25家医院在2008年3月至2011年2月之间，从评估围产期卓越的数据集。所有病例的病态粘连胎盘进行了鉴定。产妇的人口统计学资料，程序进行，产妇和新生儿outcomes.RESULTS结果：有158名妇女与病态粘连胎盘（1/731出生，95%置信区间1/632-866）。18%的病态胎盘粘连的妇女是未经产的，37%的妇女没有剖腹产史。只有53%（84/158）在分娩前怀疑有病态胎盘粘连。产前怀疑有胎盘粘连的妇女发生大量失血（33%）、子宫切除术（92%）和重症监护病房（39%），而产前未怀疑有胎盘粘连的妇女分别为19%、45%和22%（P
OBJECTIVE: To describe recent maternal and neonatal delivery outcomes among women with a morbidly adherent placenta in major centers across the United States.METHODS: This study reviewed a cohort of 115,502 women and their neonates born in 25 hospitals in the United States between March 2008 and February 2011 from the Assessment of Perinatal EXcellence data set. All cases of morbidly adherent placenta were identified. Maternal demographics, procedures undertaken, and maternal and neonatal outcomes were analyzed.RESULTS: There were 158 women with a morbidly adherent placenta (1/731 births, 95% confidence interval 1/632-866). Eighteen percent of women with a morbidly adherent placenta were nulliparous and 37% had no prior cesarean delivery. Only 53% (84/158) were suspected to have a morbidly adherent placenta before delivery. Women with a prenatally suspected morbidly adherent placenta experienced large blood loss (33%), hysterectomy (92%), and intensive care unit admission (39%) compared with 19%, 45%, and 22%, respectively, in those not suspected prenatally to have a morbidly adherent placenta (P