■比较佛山市有或没有子宫瘢痕覆盖的前置胎盘(PP)的母婴结局,中国。
■一项回顾性队列研究将所有单胎妊娠与PP进行了比较,大学附属医学中心2012年1月1日至2017年4月31日在佛山,中国。人口统计,从电子病历(EMR)中提取临床和实验室数据.通过统计学方法比较有和没有子宫瘢痕覆盖的PP的母婴结局。
■在研究期间有58,062例分娩,其中726(1.25%)是单胎妊娠中的复杂PP,并进一步分为两组:覆盖子宫瘢痕组的PP(PPCS,n=154)和不覆盖子宫瘢痕组的PP(非PPCS,n=572)。总的来说,早产(<37周,67.5%对54.8%;P=0.019),剖宫产(100%vs97.6%;P=0.050),术中出血量>1000mL(77.9%vs16.0%;P<0.001)或>3000mL(29.9%vs3.0%;P<0.001),分娩后2-24小时内出血(168.2±370.1mlvs49.9±58.4ml;P<0.001),产后出血(48.7%vs15.7%;P<0.001),输血(34.6%vs16.1%;P<0.001),出血性休克(7.8%vs1.9%;P<0.001),子宫切除术(2.6%vs0.5%;P=0.019),PPCS组和非PPCS组之间的胎儿窘迫(35.7%vs12.1%;P<0.001)和1分钟时的APGAR评分(15.2%vs7.1%;P=0.002)有显着差异。根据是否合并胎盘植入谱系障碍(PASD)进行分组后,我们发现PPCS与术中失血量>1000mL显著相关,术中失血量>3000mL,分娩后2-24小时内出血和胎儿窘迫比Non-PPCS组。
■根据妊娠合并PASD或胎盘位置不同进行分组后,PPCS组比非PPCS组有较差的母婴结局。
UNASSIGNED: To compare the maternal and neonatal outcomes of placenta previa (PP) with and without coverage of a uterine scar in Foshan, China.
UNASSIGNED: A retrospective cohort study comparing all singleton pregnancies with PP was conducted at a tertiary, university-affiliated medical center from 1 January 2012 to 31 April 2017 in Foshan, China. Demographic, clinical and laboratory data were extracted from electronic medical records (EMRs). Maternal and neonatal outcomes of PP with and without coverage of a uterine scar were compared by statistical method.
UNASSIGNED: There were 58,062 deliveries during the study period, of which 726 (1.25%) were complicated PP in singleton pregnancies and were further classified into two groups: the PP with coverage of a uterine scar group (PPCS, n=154) and the PP without coverage of a uterine scar group (Non-PPCS, n=572). Overall, premature birth (<37 weeks, 67.5% vs 54.8%; P=0.019), cesarean section (100% vs 97.6%; P=0.050), intraoperative blood loss >1000 mL (77.9% vs 16.0%; P<0.001) or >3000mL (29.9% vs 3.0%; P<0.001), bleeding within 2-24 hours after delivery (168.2±370.1 ml vs 49.9±58.4 ml; P<0.001), postpartum hemorrhage (48.7% vs 15.7%; P<0.001), transfusion (34.6% vs 16.1%; P<0.001), hemorrhage shock (7.8% vs 1.9%; P<0.001), hysterectomy (2.6% vs 0.5%; P=0.019), fetal distress (35.7% vs 12.1%; P<0.001) and APGAR score at 1 min (15.2% vs 7.1%; P=0.002) had a significant difference between PPCS group and Non-PPCS group. After grouping by whether complicated with placenta accreta spectrum disorders (PASD), we found that PPCS was significant associated with more intraoperative blood loss >1000mL, intraoperative blood loss >3000mL, bleeding within 2-24 hours after delivery and fetal distress than the Non-PPCS group.
UNASSIGNED: The PPCS group had poorer maternal and neonatal outcomes than the Non-PPCS group after grouping by whether pregnancies complicated with PASD or with different placental positions.