Prolonged adhesiolysis to pregnancy interval is associated with placenta accreta spectrum in women with intrauterine adhesion.

IF 0.9 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Pub Date : 2024-12-01 Epub Date: 2024-07-15 DOI:10.1080/01443615.2024.2378420

Lan Xiang, Duoxiang Sun, Juan He, Yali Zhuang

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Abstract

Background: Both the trauma of endometrium and hysteroscopic adhesiolysis can lead to a high rate of placenta accreta spectrum (PAS) in women with intrauterine adhesion (IUA). This study analysed the impact of time interval from adhesiolysis to pregnancy on PAS in IUA women.

Methods: Patients diagnosed with IUA who underwent adhesiolysis in Anhui Women and Children's Medical Centre between January 2016 and December 2020 were included in this case-series study. Clinical data were obtained from electronic medical records and telephone interviews.

Results: Among a total of 102 IUA women with successful pregnancies, 8 (7.8%) suffered from miscarriages with PAS, and 94 (92.2%), 47 with PAS and 47 without PAS, had successful delivery. The total prevalence of PAS in pregnant women with IUA was 53.9% (55/102). The average time from adhesiolysis to pregnancy in the PAS group was significantly longer than in the non-PAS group (14.2 ± 5.7 vs. 10.3 ± 4.4 months, p = 0.000). Regression analysis showed that AFS grade (OR = 7.40, 95% CI 1.38-39.73, p = 0.020) and adhesiolysis to pregnancy interval time between 12 and 24 months (OR = 12.09, 95% CI 3.76-38.83, p = 0.000) were closely related to PAS. A Kaplan-Meier analysis showed the median interval time to PAS was 16.00 months (95% CI 15.11-16.89).

Conclusions: We assume that prolonged adhesiolysis to pregnancy interval may be considered a significant risk factor for PAS in IUA women.

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延长宫腔粘连妇女的妊娠间隔与胎盘早剥谱相关。

背景：子宫内膜的创伤和宫腔镜粘连分解术均可导致宫腔内粘连（IUA）妇女发生胎盘植入谱（PAS）的高比率。本研究分析了从粘连分解到怀孕的时间间隔对 IUA 妇女胎盘早剥的影响：本病例系列研究纳入了2016年1月至2020年12月期间在安徽省妇女儿童医疗中心接受粘连分解术的确诊IUA患者。临床数据来自电子病历和电话访谈：在102名成功妊娠的IUA妇女中，8名（7.8%）流产并伴有PAS，94名（92.2%）成功分娩，其中47名伴有PAS，47名未伴有PAS。在患有 IUA 的孕妇中，PAS 的总发病率为 53.9%（55/102）。PAS 组从粘连溶解到怀孕的平均时间明显长于非 PAS 组（14.2 ± 5.7 个月 vs. 10.3 ± 4.4 个月，P = 0.000）。回归分析表明，AFS 分级（OR = 7.40，95% CI 1.38-39.73，p = 0.020）和 12 至 24 个月的妊娠间隔时间（OR = 12.09，95% CI 3.76-38.83，p = 0.000）与 PAS 密切相关。Kaplan-Meier 分析显示，PAS 的中位间隔时间为 16.00 个月（95% CI 15.11-16.89）：我们认为，粘连溶解至妊娠间隔时间过长可被视为 IUA 妇女发生 PAS 的一个重要风险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Obstetrics and Gynaecology 医学-妇产科学

CiteScore

2.40

自引率

7.70%

发文量

398

审稿时长

6 months

期刊介绍： Journal of Obstetrics and Gynaecology represents an established forum for the entire field of obstetrics and gynaecology, publishing a broad range of original, peer-reviewed papers, from scientific and clinical research to reviews relevant to practice. It also includes occasional supplements on clinical symposia. The journal is read widely by trainees in our specialty and we acknowledge a major role in education in Obstetrics and Gynaecology. Past and present editors have recognized the difficulties that junior doctors encounter in achieving their first publications and spend time advising authors during their initial attempts at submission. The journal continues to attract a world-wide readership thanks to the emphasis on practical applicability and its excellent record of drawing on an international base of authors.