瘢痕子宫与无瘢痕子宫低位胎盘和前置胎盘的胎儿-母体结局比较：一项前瞻性观察研究
Comparison of Feto-Maternal Outcome in Low-Lying Placenta and Placenta Previa in Scarred Versus Unscarred Uterus: A Prospective Observational Study.
摘要(中文译文)
瘢痕子宫患者胎盘植入缺陷的发生率较高。鉴于这是晚期妊娠出血的主要原因，本研究旨在比较低置胎盘和前置胎盘合并瘢痕子宫与无瘢痕子宫女性的母胎结局。研究纳入妊娠28周及以后的低置胎盘和前置胎盘女性。制定了符合研究目标的预测试表格，并采集了详细病史。记录并比较瘢痕子宫组与无瘢痕子宫组的母体及胎儿并发症。无瘢痕子宫女性中低置胎盘和前置胎盘的发生率（0.91%）显著低于瘢痕子宫女性（3.20%）（p<0.05）。瘢痕子宫女性的总体失血量（p≤0.05）及母体并发症发生率较高，包括胎盘植入谱系疾病（p=0.014）、产后出血（p=0.002）、处理这些并发症所需的手术干预（p=0.09）以及入住重症监护病房（p=0.009）。瘢痕子宫女性分娩期间接受大量输血（>5单位血液）的比值比为4.11（95% CI：1.30-13.56）。剖宫产术中失血量与分娩时孕周呈显著负相关线性关系。瘢痕子宫合并前置胎盘可独立增加胎盘植入谱系疾病、产后出血、输血及入住重症监护病房的风险。这些女性接受挽救生命干预措施的几率更高。在较低分娩孕周进行此类干预与显著的产品后出血相关。
Abstract
A scarred uterus has a high incidence of defective implantation of the placenta. This being a major cause of third-trimester haemorrhage, we undertook this study to compare the feto-maternal outcome in women with low-lying placenta and placenta previa having scarred and unscarred uterus. Women with low-lying placenta and placenta previa at or after 28 weeks of gestation were recruited for the study. A pretested proforma meeting the objectives of the study was prepared, and a detailed history was taken. Maternal and foetal complications were noted and compared between the groups having scarred and unscarred uterus. The incidence of low-lying placenta and placenta previa was significantly lower in women with unscarred uterus (0.91%) compared to scarred ones (3.20%) (p<0.05). The overall blood loss (p≤0.05) and maternal complication rates, viz. placenta accreta syndrome (p=0.014), postpartum haemorrhage (p=0.002), surgical interventions (p=0.09) to manage these complications, and intensive care unit admission (p=0.009), were high in women with scarred uterus. A woman with a scarred uterus had an odds of 4.11 (95% CI: 1.30-13.56) to undergo massive blood transfusion (>5 units of blood) during delivery. There was a significant inverse linear correlation of blood loss during caesarean section and gestational age at delivery. Scarred uterus with placenta previa can independently increase the risk of placenta accreta spectrum, postpartum haemorrhage, blood transfusion, and admission to intensive care units. These women have higher odds of undergoing lifesaving interventions. Such interventions at a lower gestational age of delivery are associated with significant postpartum haemorrhage.
如何引用
AMA
Vaibhav Kanti, Smriti Sagar, Pragati Divedi, Banashree Nath, Nupur Mittal, Snehlata Meena. Comparison of Feto-Maternal Outcome in Low-Lying Placenta and Placenta Previa in Scarred Versus Unscarred Uterus: A Prospective Observational Study.. Cureus. 2026; doi:10.7759/cureus.108402.
APA
Vaibhav Kanti, Smriti Sagar, Pragati Divedi, Banashree Nath, Nupur Mittal, Snehlata Meena (2026). Comparison of Feto-Maternal Outcome in Low-Lying Placenta and Placenta Previa in Scarred Versus Unscarred Uterus: A Prospective Observational Study.. Cureus. https://doi.org/10.7759/cureus.108402
GB/T 7714
Vaibhav Kanti, Smriti Sagar, Pragati Divedi, Banashree Nath, Nupur Mittal, Snehlata Meena. Comparison of Feto-Maternal Outcome in Low-Lying Placenta and Placenta Previa in Scarred Versus Unscarred Uterus: A Prospective Observational Study.[J]. Cureus, 2026 doi:10.7759/cureus.108402.
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