The nightmare of obstetricians - the placenta accreta spectrum in primiparous pregnant women.

IF 1.2 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Ülkü Ayşe Türker Aras, Engin Korkmazer, Emin Üstünyurt
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Abstract

Objectives: The incidence of PAS is increasing day by day as a life-threatening condition. The purpose of the present study was to determine the factors affecting PAS formation in primiparous pregnant women and to define possible risk factors for the mother and the baby.

Material and methods: Bursa Yüksek İhtisas Training and Research Hospital, department of obstetrics and gynecology, Bursa, Turkey, between June 2016 and December 2020. A total of 58,895 patients were included in the study. After the exclusion criteria, the study was continued with 27 primiparous PAS and 54 non-primiparous PAS patients. The primary purpose is to evaluate PAS risk factors. The secondary aim is to examine maternal and neonatal characteristics.

Results: When the parameters that are significant in terms of PAS risk factors were analyzed by Logistic Regression Analysis, it was found that the increase in age also increased the development of PAS 1.552 times (95% CI: 1.236-1.948) and a history of abortion was 7.928. times (95% CI: 1.408-44.654) and 11,007 times (95% CI: 2.059-58.832) with history of myomectomy; postoperative HB values (p < 0.001), an estimated amount of bleeding (p < 0.001), need for transfusion (p = 0.002), and use of drains ( < 0.001) were statistically significant different between two groups. When the neonatal results between patients with and without PAS were examined, birth weight (p < 0.001) and gestational week ( < 0.001) were statistically significant.

Conclusions: PAS does not occur only in multiparous patients who have a history of previous cesarean section. It may also occur in primiparous patients and is a life-threatening condition.

产科医生的噩梦——初产孕妇的胎盘增生谱。
目的:作为一种危及生命的疾病,PAS的发病率日益增加。本研究的目的是确定影响初产孕妇PAS形成的因素,并确定母亲和婴儿可能的危险因素。材料和方法:2016年6月至2020年12月,Bursa y ksek İhtisas培训和研究医院,土耳其Bursa妇产科。共有58,895名患者参与了这项研究。排除标准后,继续对27例初产PAS患者和54例非初产PAS患者进行研究。主要目的是评估PAS的风险因素。次要目的是检查产妇和新生儿的特征。结果:Logistic回归分析PAS危险因素中有显著意义的参数时发现,年龄的增加也使PAS的发生增加了1.552倍(95% CI: 1.236 ~ 1.948),流产史增加了7.928倍。两次(95% CI: 1.408 ~ 44.654)和11,007次(95% CI: 2.059 ~ 58.832);术后HB值(p < 0.001)、估计出血量(p < 0.001)、需要输血(p = 0.002)和使用引流管(p < 0.001)两组间差异均有统计学意义。当检查有和没有PAS患者的新生儿结果时,出生体重(p < 0.001)和妊娠周(< 0.001)具有统计学意义。结论:PAS并不仅仅发生在有剖宫产史的多次分娩患者中。它也可能发生在初产妇身上,是一种危及生命的疾病。
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
Ginekologia polska
Ginekologia polska OBSTETRICS & GYNECOLOGY-
CiteScore
2.00
自引率
15.40%
发文量
317
审稿时长
4-8 weeks
期刊介绍: Ginekologia Polska’ is a monthly medical journal published in Polish and English language. ‘Ginekologia Polska’ will accept submissions relating to any aspect of gynaecology, obstetrics and areas directly related. ‘Ginekologia Polska’ publishes original contributions, comparative works, case studies, letters to the editor and many other categories of articles.
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