与持续性前置胎盘相关的母体危险因素,Placenta

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与持续性前置胎盘相关的母体危险因素
Placenta ( IF 3.0 ) Pub Date : 2020-09-01 , DOI: 10.1016/j.placenta.2020.08.004
Luke J King ₁ , A Dhanya Mackeen ₁ , Cara Nordberg ₂ , Michael J Paglia ₁

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引言与前置胎盘相关的母体危险因素在文献中有详细记载。然而，确定与前置胎盘持续存在相关的母体特征的研究有限。该研究的目的是确定与持续性前置胎盘相关的母体特征。方法一项回顾性队列研究在 2003 年至 2017 年期间从单一机构确定了 705 名被诊断为妊娠 17 至 24 周之间的低位胎盘或前置胎盘的孕妇。主要结果包括持续性前置胎盘（即持续性前置胎盘）。 36 周 0 天或之后 2 cm 内的组织。胎盘异常（如前置血管、胎盘植入）或在 36 周 0 天前分娩的患者被排除在外。在诊断为前置胎盘或低位胎盘的女性中，使用多变量逻辑回归模型来确定与持续性前置胎盘相关的显着母体特征。结果有剖宫产史的妇女发生持续性前置胎盘的可能性高 7 倍（比值比，7.0，95% 置信区间，3.7-13.1）。在前置胎盘的情况下宫腔刮宫或清宫的病史使持续性前置胎盘的可能性增加近 3 倍（优势比，2.5，95% 置信区间，1.3-5.0）。讨论迄今为止，我们的研究是评估与持续性前置胎盘相关的母亲危险因素的最大的回顾性队列研究；

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Maternal risk factors associated with persistent placenta previa

INTRODUCTION Maternal risk factors associated with placenta previa are well documented in the literature. However, there are limited studies identifying maternal characteristics associated with the persistence of placenta previa. The objective of the study was to determine maternal characteristics associated with the persistent placenta previa. METHODS A retrospective cohort study was conducted in which 705 pregnant women diagnosed with low-lying placenta or placenta previa between 17 and 24 weeks gestation were identified from a single institution between 2003 and 2017. The primary outcome included persistent placenta previa (i.e., persistent placental tissue within 2 cm of the internal os) at or after 36 weeks 0 days. Those with abnormal placentation (e.g., vasa previa, placenta accreta) or delivery prior to 36 weeks 0 days were excluded. Multivariable logistic regression modeling was utilized to determine significant maternal characteristics associated with persistent placenta previa among women diagnosed with either placenta previa or low-lying placenta. RESULTS Women with a prior cesarean delivery were seven times more likely to have persistent placenta previa (odds ratio, 7.0, 95% confidence interval, 3.7-13.1). A history of intrauterine curettage or evacuation in the setting of placenta previa increases the likelihood of persistent placenta previa almost 3-fold (odds ratio, 2.5, 95% confidence interval, 1.3-5.0). DISCUSSION To date, our study is the largest, retrospective cohort study assessing maternal risk factors associated with persistent placenta previa; and is the first to detect a statistically significant correlation between a history of intrauterine surgeries and persistent placenta previa.

更新日期：2020-09-01

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